Inspection on 06/12/06 for Grays Court

This inspection was carried out on 6th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Grays Court 08/05/07

Grays Court 13/12/05

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

CARE HOMES FOR OLDER PEOPLE Grays Court Church Street Grays Essex RM17 6EG Lead Inspector Mrs Nikki Gibson Unannounced Inspection 6th December 2006 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 Grays Court DS0000065444.V323628.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. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grays Court Address Church Street Grays Essex RM17 6EG 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) 01375 376667 01375 397497 Minster Care Management Limited Mrs Charlotte Mary Dean Care Home 87 Category(ies) of Dementia - over 65 years of age (52), Old age, registration, with number not falling within any other category (87) of places Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2006 Brief Description of the Service: Grays Court Care Home provides personal care and accommodation for eightyseven older people of whom up to fifty two may have a diagnosis of dementia. The home is purpose built and is designed round a central courtyard, which provides an attractive garden area with seating. Accommodation is provided on two floors and is divided into four units. Each unit is self contained with small kitchen for snacks, dining room and lounges. There is ample space with small lounges, which can be used for a variety of activities. All bedrooms have spacious en-suite facilities. There is a small shop on the premises for resident’s and staff use. The home has a designated activity room with attractive displays. The Grays Court is within easy reach of trains, buses and local facilities. The email address is grayscourtcarehome@msn.com The most recent inspection report was readily available in the entrance hall of the home. In May 2006 the fees were from £420 to £510. Residents paid additionally for hairdressing, chiropody, newspapers, toiletries, cigarettes, confectionary and taxis. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The previous inspection in September 2006 raised a large number of concerns about the standard of care at Grays Court which were documented in the inspection report. This inspection was made to see what progress had been made. This was an unannounced inspection which covered all the key National Minimum Standards. The site visit took place over 7 hours by two regulation inspectors. During the visit there was a tour of the premises and a selection of records and documents were studied. Time was spent in the lounges and dining rooms, observing practice and with residents in their own rooms. The inspection process also included discussions with the manager, staff and relatives. Other reports and correspondence provided by the proprietor were also used as evidence to inform this report. As Part of this unannounced inspection the quality of information given to people about the care home was looked at. The information included the service user’s guide, contract and complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk The proprietor, manager, staff, and residents were most helpful and this was greatly appreciated. Discussion of the inspection findings took place with the Manager and proprietor at the end the inspection and guidance was given. What the service does well: What has improved since the last inspection? Notable improvements had been made in the standard of service provided at Grays Court since the last inspection. The two care plans studied which had been completed by the same carer were of a high standard and showed an in depth understanding of the residents’ needs with clear instructions for staff to follow. Pre-admission assessments now form part of the care plan. Improvements had been made to the storage and administration of medication. Activities are being made more available to Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 6 residents who wish to stay in their rooms or lounges. Signage was increasing to help orientate residents. Improvements to the environment are beginning to have a positive effect. Staffing levels and recruitment procedures have improved. Monthly audits are taking place and copies of the report sent to the manager and the CSCI. 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. Grays Court DS0000065444.V323628.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 Grays Court DS0000065444.V323628.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): 12346 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents and their supporters receive information about the home so that they can make an informed choice. Pre-admission assessments are undertaken by competent staff and the information shared with care staff. EVIDENCE: A copy of the Statement of Purpose and Service User Guide were on display in the hall. The home’s Service User Guide has been up dated to provide information about the new owners. It was a clear document which included a number of useful contact details and information about local places of worship and Public Houses. The manager said that a copy had been placed in each residents’ room. Residents spoken to were not aware of this. Many lacked capacity to discuss the Service User Guide, others said that their family or social services had chosen the home. A relative of a new resident said she had not been given a copy of the Service User Guide. Care must be taken that residents and their supporters get copies of the Service User Guide before a decision is made to use the home so that they can make an informed choice. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 9 All residents have a contract or letter of terms and conditions. Relatives were informed by letter of the change of ownership and any changes in fees and a copy is kept on the residents file. The manager said that old contracts have not been renewed to reflect this. Some confusion about the changes of payment of fees was experienced when Minster Care first took over which is generally resolved now. Each prospective resident is assessed by someone competent to do so prior to a place being offered. Places are not offered if needs cannot be successfully met. Since the last inspection all pre-admission assessments form part of the residents care plan. The home is registered for the specialist category of people with dementia. Up to fifty two residents with dementia are cared for on two large units and this poses a considerable challenge. In the past this challenge has not been adequately met, however improvements in care are being made. There have not been any recent complaints and training and staffing awareness are beginning to reflect the needs of the residents. Grays Court does not provide Intermediate Care. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans studied showed a good insight into the residents needs and there were comprehensive instructions for staff on how the home was to meet them. Residents have appropriate access to health care services. Medication is stored, recorded and administered safely. Residents are treated with dignity and respect. EVIDENCE: The improvement plan from the last inspection details that social service reviews and feedback, and pressure sore management, will be incorporated into each residents’ care plan. The reordering of the care plan and Life Stories will be completed by January 2007. Two care plans were studied in detail and evidenced that improvements had been made. The documents were completed more fully and changes in the residents needs were recorded. Instructions for staff were clear and detailed, for example, “Carers will need to be patient and allow X the time to respond to questions. She communicates better on a one to one basis with a carer in a quiet environment with no distractions or background noise.” There were other examples of excellent Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 11 detailed instructions. The care plans studied did not evidence that monthly reviews are taking place, however these are being introduced and the registered manager plans to carry out monthly care plan audits to ensure compliance. The care plans studied showed that staff are making appropriate referrals to out side medical agencies and there was a clear record of multi-disciplinary involvement. A record is kept of District Nurse visits including any treatment or advice given. Details of medication prescribed ‘as and when required’ (PRN) were carefully recorded with detailed instructions on how to communicate with the resident to ensure they get the pain relief that they need. Previously the administration of medication had been of such a poor and unsafe standard that a Statutory Requirement Notice was issued. A follow up visit was made by a pharmacist inspector who reported big improvements. At this inspection seven residents’ medication profiles and blister packed medications were examined. There were no omissions or anomalies noted. The temperature of the medication fridge and room were recorded daily to ensure that medication was stored appropriately. Medication whose expiry date is shortened on opening had the date of opening written on the label. The controlled drugs register was inspected and the figures and actual numbers balanced. All senior staff now have ASET one day foundation training from Boots and three have completed the advanced level. The administration of medication was much improved. It was recommended as good practice that Risk Assessments are undertaken for all identified areas of risk i.e. spitting out medication, epilepsy. Staff spoke of residents with dignity and respect. Doors were closed when personal care was given and residents were referred to by the term of address they preferred. A senior member of staff spoken to had a clear knowledge of the residents and provided activities such as dusting to a resident who enjoyed being useful. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 12 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): 11 12 13 14 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A variety of pastimes are provided to suit a range of needs and interests. Relatives are made welcome. Residents are able to make some choices and independence is encouraged. Food is of a good standard and there is a choice at all meal times. EVIDENCE: It was pleasing to see a variety of activities were taking place on different units. Staff were talking with residents, one was providing a hand massage, another was playing a board game and another was playing a word game. A group of residents were enjoying doing a crossword in the activity room and another member of staff was providing manicures. Some residents were having their hair done. It was noted positively that all staff were interacting well with residents and providing meaningful activities which will greatly improve the quality of life for the residents. Residents work was attractively displayed in some areas of the home. Consideration was being given to moving the activities room so that the kitchenette could be used by residents for cooking activities. The home is to be commended on the improvements it has made to provide meaning pastimes for all the residents. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 13 Relatives and visitors are made welcome and are encouraged to use the kitchenette facilities. Independence is encouraged and in one care plan was written that a resident could dress and undress herself but needed guidance to put clothes on in the right order, it went on to say, “All carers need to ensure X’s continued independence by allowing her to do as much as possible for herself”. Lunch in one unit was observed. Residents chose the day before from a range of meal options. The meal was served from a hot trolley by the senior carer. Last minute changes by residents could be catered for. The food smelt appetising and was presented attractively. A resident said the food was good and there was always a choice. Hot meals are available three times a day. The small kitchenettes are an excellent facility in the home enabling staff to be flexible with snacks and drinks and enabling residents to maintain some independence. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home has made improvements to the way that complaints are recorded. Training is on going however not all staff have received adequate training in the protection of vulnerable adults. EVIDENCE: The complaints procedure is detailed in the Statement of Purpose and Service User Guide and a copy is displayed in the entrance hall. The home is introducing a new way of recording complaints which will be clearer and which should evidence the investigation of the complaint, the outcome and how it has been shared with the complainant. This should reassure residents, staff and visitors to the home that their complaints are taken seriously and acted on. One resident said they were generally happy with the care, but “sometimes people (staff) are careless and do not want to bother”. When asked they said that if they made a complaint they felt that staff would listen. The home has a clear abuse policy which identifies the correct action to take following an allegation of abuse. The home also had a Whistle blowing Policy Study of an updated training matrix showed that 28 care staff had recent Protection of Vulnerable Adults training, however 17 care staff had not received any training. Action needs to be taken to ensure that all staff know how to identify possible abuse and are confident and knowledgeable of the action to be taken. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 21 22 24 26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The home is clean and odour free. Some areas are clinical while others have been made homely and bright. Improvements to the environment have been made over the past year and this needs to continue. EVIDENCE: Grays Court is designed round a central courtyard. The building is divided into four units. Improvements have been made to the environment. Some new chairs were evident. Some corridors were attractively decorated with posters, displays, photographs, poems and residents’ artwork. Other corridors were bare and clinical with no signage. One corridor still contains a ‘nurses station’ which detracted from the homely feel the home was trying to foster. Confidential material was displayed on the walls. It is understood that some parts of the home are still waiting to be upgraded. As part of the registration agreement Minster Care Management Ltd were required to provide a development plan detailing the refurbishment and redecoration that they Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 16 intended and the time scale. To date this has not been provided and the proprietor is required to forward this to the CSCI within a week of receiving this report. The Ballroom is an improved space for residents with new chairs and carpet and most of the inappropriate storage has gone. Stained carpets have been replaced in lounges. One ‘lounge’ is used by the hairdresser, the home may like to consider furbishing a room to look like a Hairdressers to add to the experience of the residents. Some bathrooms are classed as sensory rooms and this is to be commended, however other bathrooms and toilets are clinical and bare. In one unit a resident was seen asking and searching for the toilet, as the doors were not labelled this was particularly difficult. In other units signage is in place and clear. The home said at the last inspection that signage would be provided throughout the home. A stand aid hoist was seen being charged in an office out of the way of residents. This is used by few residents however as they are accommodated on different units there is a problem of logistics of finding and getting the hoist to the residents who need it. To address this the home has ordered a second hoist so that there will be at least one shared by two units on each floor. Residents bedrooms inspected were clean and tidy and had been personalised. Residents who wished had small refrigerators in their rooms. In some units bedroom doors had laminated photograph and name of the resident The laundry was not inspected on this occasion. Unwrapped pads were observed in open bins in two bathrooms, however staff said this was definitely not normal practice. Lidded bins must be provided in all bathrooms to reduce the risk of odour and cross infection. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Poor staffing levels have been a serious concern but are now improving. Training is being offered, however there is still gaps in training and skills mix in the home which needs to be addressed. EVIDENCE: Staffing levels considered necessary to meet the needs of residents are: 1 senior and 3 care staff in the 22 bedded residential unit 1 senior and 2 care staff in the high dependency 10 bedded residential unit 1 senior and 3 care staff on the 23 bedded dementia unit 1 senior and 4 care staff on the 29 bedded dementia unit. 1 senior and 1 carer on each unit at night is the absolute minimum and more staff are likely to be required in the dementia units. In addition the manager and deputy are supernumerary and there needs to be additional daily support for domestic and catering duties and designated activities co-ordinators. The high dependency unit was not maintaining this staffing level and this was discussed with the proprietor who agreed to maintain the staffing level until dependency levels in this unit were lowered. The senior said the unit runs much better with three staff as several residents require the assistance of two staff. Some units ran without a senior in charge for some shifts. This is Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 18 unacceptable and the manager said that seniors would be appointed when appropriately trained and experienced staff were available. A newly appointed senior carer said, “I really want to get it right. If I have any concerns I talk to the manager who is really supportive and reassuring”. A junior member of staff said, “the seniors are pretty hands on in this unit”. The staff training matrix available at the time of the inspection was not up to date. However a copy was provided a few days after the inspection. A high proportion of care staff working days had undertaken NVQ level 2 in care however only one night carer had this qualification. The matrix clearly showed were gaps in training need to be addressed. Two staff files were sampled. Both files were well organised with a checklist. All documentation required was available and references had been verified. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements in staff morale were evident. A continued increase in senior and management staff should facilitate the improvements the home is making. EVIDENCE: There have been some changes in the management structure in the home. The manager has recently completed the NVQ level 4 in Care and plans to do the Registered Managers Course. She said the home had been through a stressful time, but now the staff were working better together and the home was generally calmer. There are plans to employ a deputy manager in January 2007. The deputy will be supernumerary to the staffing level, but will be based in the large dementia unit. Management cover will be provided at weekends to ensure a high standard is maintained at all time. This is to be commended as in the past there has been insufficient management cover in Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 20 the home. The manager said she would also be working some evenings to meet with night carers and monitor the care at night. There was much improvement in the home which must be maintained. The registered manager said she was back in control and feeling more positive. The home was less defensive in its approach to the inspection and were more open to advice and guidance. Questionnaires for relatives to complete as part of the homes Quality Assurance Audit were available in the entrance hall. Monthly audits of the home have been taking place and copies provided to the manager and CSCI in line with Regulation 26. Study of staff files showed that supervision is being introduced. The registered manager stated that they were working through staff supervision although there was a lot to catch up on. The plan is for all staff to have two monthly supervision and a yearly appraisal. The registered manager will supervise the senior staff and senior staff will supervise junior staff. The accident book was inspected and it was noted positively that the manager was highlighting residents who have frequent falls so that causes can be identified and risks reduced. The fire log was studied and showed that the alarm system and automatic door releases are tested weekly this was confirmed by a resident and the maintenance person. Fire fighting equipment is checked monthly by the maintenance person who is also the fire marshal. A Portable Appliance test certificate was available. Gas and Electric safety certificate could not be found and copies were requested to be sent to the CSCI. These have yet to be received. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 2 2 X 3 X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 2 Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement The Registered Person must keep the service user plan under review with consultation with the resident or their representative. The Registered Person must make arrangements to prevent residents from being abused. This refers to policies and procedures being in place and known to staff and training being provided. (Previous timescale of 03/11/06 not met) The Registered Provider must produce an action/development plan detailing the improvements to be made to the environment, which was part of the registration agreement and is now well over due. (Previous timescale of 10/02/06 and 05/06/06 and 03/11/06 not met) The Registered Provider must ensure that the environment is adapted to meet the needs of the residents including clear signage. (Previous timescale of 10/02/06 DS0000065444.V323628.R01.S.doc Timescale for action 01/02/07 2 OP18 13(6) 01/02/07 3 OP19 23 01/02/07 4 OP21 16(1) 01/02/07 Grays Court Version 5.2 Page 23 5 OP22 13(5)) 6 OP26 16 7 OP27 18(1) 8 OP28 18 (1) 9 OP38 13(4) and 03/11/06 not met) The Registered Person must make suitable arrangements for the safe moving of residents. This refers to insufficient standing hoists being available. (Previous timescale of 05/06/06 and 03/11/06 not met) The Registered Person must make arrangements to prevent the spread of infection and ensure satisfactory standards of hygiene. This refers specifically to ensuring that all continence aids are disposed of appropriately. The Registered Person must ensure that at all times there are suitably qualified, competent, and experienced persons working at the Home in such numbers as are appropriate for the health and welfare of the residents. (Previous timescale of 10/02/06 05/06/06 and 03/11/06 not met) A copy of the homes minimum staffing levels for each unit for day and night staff to be sent to the CSCI within one week of receipt of this report. The Registered Person must ensure that staff employed receive the training appropriate to the work they are to perform. This relates to gaps in training particularly regarding night staff. The Registered Person must ensure that risks are identified and so far as possible eliminated. This refers to providing for inspection copies of the Gas and Electric safety certificates. Copies to be sent to the CSCI within one week of receipt of report. DS0000065444.V323628.R01.S.doc 01/02/07 01/02/07 01/02/07 01/02/07 01/02/07 Grays Court Version 5.2 Page 24 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 Copies of the Statement of Purpose and Service User Guide should be made available to prospective residents and their supporters before a decision to move in has been made so that an informed choice can be made. Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Grays Court DS0000065444.V323628.R01.S.doc Version 5.2 Page 26 - 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!