Inspection on 27/11/07 for Green Lane House

This inspection was carried out on 27th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Green Lane House 01/12/08

Green Lane House 04/10/06

Green Lane House 02/03/06

Green Lane House 04/10/05

Green Lane House 14/03/05

Green Lane House 08/09/04

Green Lane House 12/03/04

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

CARE HOMES FOR OLDER PEOPLE Green Lane House Green Hill Brampton Cumbria CA8 1SU Lead Inspector Diane Jinks Unannounced Inspection 27th November 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 Green Lane House DS0000043390.V352372.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. Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Green Lane House Address Green Hill Brampton Cumbria CA8 1SU 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) 01697 72345 claire@greenlanehouse.com Greenlane Care Homes Ltd Mrs Claire Pratt Care Home 28 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (28) of places Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 28 service users to include: up to 28 service users in the category of OP (old age not falling within any other category) up to 5 service users in the category DE(E) (Dementia over 65 years of age) The home is registered from time to time to admit persons between the ages of 60 and 65 years of age. 4th October 2006 2. Date of last inspection Brief Description of the Service: Green Lane House is a period home, on the outskirts of Brampton, set in extensive well-maintained gardens with ample car parking. There are 25 bedrooms, 7 of which are en-suite, with additional communal facilities of three bathrooms and four separate toilets. There are three lounge areas, which open onto patios, and an additional smaller room, which is designated as a smoking area. The home has a passenger lift, ramps, handrails and has suitable furniture and equipment to met the needs of people using this service. The home produces a guide to the services and facilities it can provide. This is available on request from the manager. The scale of charges range from £373.00 - £434.00 per week (November 2007), subject to an assessment. There are extra charges for hairdressing, magazines, chiropodists and other personal items that service users may wish to have. Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The assessment of this service took place over several weeks and included a visit to the home. People using this service, staff, visitors and relatives were asked for their views and opinions about the home, either during the visit or by completing questionnaires. The manager was spoken to and completed an Annual Quality Assurance Assessment, which helped verify information throughout the inspection process. What the service does well: What has improved since the last inspection? What they could do better: Some areas of the home have been re-decorated to help make the general environment more pleasant. There are areas of the home that need to be improved and upgraded, particularly the communal bathrooms where there are potential risks to the control of infection. Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 6 The way in which care plans are developed and updated needs to be reviewed to ensure that any changes in health or social care needs are clearly recorded. This includes making sure that people living at the home have a detailed assessment of their nutritional needs and requirements. Although the people participating in the assessment of this service are generally satisfied with the food at the home, the menus indicate that a balanced diet is not always provided. Menus need to be revised to ensure that people using this service are provided with a nutritionally balanced diet. Consideration should also be given to the dining arrangements, as the home does not have a designated dining room. One person noted ‘‘It would be better if they had a dining room without gate leg tables as these are very difficult for old people to sit around comfortably. 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. Green Lane House DS0000043390.V352372.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 Green Lane House DS0000043390.V352372.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): Standards 1 and 3. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People using this service do not always receive a comprehensive assessment of their health and social care requirements. This means that their needs and expectations may not always be met in the most appropriate way. EVIDENCE: The manager and proprietor have produced information booklets (Statement of Purpose and Service User Guide) about the home and the services that it can provide. This information helps prospective residents to make a decision about whether the home will be suitable and able to meet their needs and expectations. A sample of three care files was looked at during the visit to this service. Two of the files contain pre-admission assessments. The documents do not provide a great deal of information about the health and social care needs of these people. One of the files looked at does not have an assessment at all. Pre-admission assessments help the manager or assessor to decide whether the home will be able to meet the health and social care needs of people Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 9 considering using this service. If assessments are not carried out thoroughly, people’s needs may be overlooked. This will affect the way in which they are cared for or supported. Green Lane House DS0000043390.V352372.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): Standards 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans generally reflect the health and social care needs of people living at the home. There are some gaps in their records, which means that people may not always have their needs and expectations met. EVIDENCE: The samples of care files looked at all contain individual plans of care. Care plans include some information about health and personal care needs and the level of support required by the people using this service. They contain an element of risk assessment including the risks of falls, pressure sores and general health and safety matters. The level of independence of each person and the areas where support is required is also identified in the plans. There is some evidence that care plans are reviewed, but any changes in care needs are not always recorded. For example, one person’s old care plans include detailed instructions for staff to follow in relation to an on-going medical condition. These instructions are not included in such detail in the most up to date plan for this person. Another person had a fall earlier in the year and sustained a fracture. There is nothing mentioned of this in the care plan nor is Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 11 there any indication that needs or support may have changed on discharge from hospital. Although body weights are monitored, detailed nutritional assessments are not undertaken as part of the care assessment or care planning process. Two of the care files looked at provide sufficient indications that full nutritional assessments and monitoring would be appropriate and in one case monitoring has been requested by a health care professional. Daily notes of significant events in the life of people living at the home are kept. The notes indicate that people have access to other health care professionals such as their doctor, podiatrist, speech and language therapist, community nurses and hospital appointments. One of the community nurses commented that the home is very good at contacting them for help or advice about healthcare matters. She said, ‘Generally if they have concerns about any of the residents they will contact the nurses for advice. The girls are spot on, they are caring motivated and patient, they have a nice manner with the residents’. The home manages most of the medication requirements of the people using this service. One person’s records show that they are responsible for some aspects of their own medication, but there is no assessment on their file to ensure that they can use this medication safely and appropriately. Medication records were looked at and were well completed. However, these records may contain errors because they were sometimes signed before medicines were actually given. Part of the medication round was observed during the visit to this home and the member of staff undertaking this task was spoken to about the procedures. She said that she has undertaken training in the administration of medication. This helps to make sure that this task is carried out safely. However, there are some unsafe practices at the home regarding the way in which medication is administered and recorded. This was discussed with the manager, as it needs to be reviewed and amended as soon as possible as it potentially places people at risk from harm. There are arrangements in place for the general storage of medicines at the home, including safe arrangements for medicines that may require specialist storage procedures. Green Lane House DS0000043390.V352372.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): Standards 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People living at the home are generally treated with respect and dignity. They are able to make some choices and have some control over their lifestyle, which helps maintain their independence. EVIDENCE: The manager has started to hold residents meetings to help obtain the views and opinions of people living at the home. We (Commission for Social Care Inspection) spoke to some of the people that work, live or visit the home. General observations of life in the home were also made. People participating in this inspection say that there are activities and social events for them to join in if they wish. A visitor said, ‘there are things organised for residents to participate in if they wish. They were out in the garden in the summer playing games too.’ Other activities mentioned include; games, flower arranging, baking and singing. On the day of this visit the manager was putting the finishing touches to the programme for December. This includes concerts in the home, trips out to Carlisle and parties. Staff were seen helping people who live at the home. They helped them to settle comfortably into chairs in one of the lounges and went to get rugs to Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 13 cover their legs if they wished. Staff made sure that personal items such as handbags and cushions were in the right place and easy for people to reach. Some people were unhappy about being upstairs. They said that the ‘lift was broken again’ and that it was always breaking down. One person said that it would be ‘a long day upstairs on her own.’ Another said that they don’t like being upstairs and would like a room on the ground floor. They said that staff know this but they felt that it is a waste of time asking. Several people living at the home say that the staff get them up at 7am and indicated that they don’t always have a choice about this. They did say that they could choose what time they go to bed though. People living at the home say that their visitors are made welcome. They are able to see them in one of the communal areas or in private, in their own room and tea and biscuits are available. People were asked about the food at the home as comments were received to suggest that suitable meals are always offered, especially at teatime. The people spoken to are satisfied with the meals provided. They say that it is generally good and there is always a choice if you don’t like something. The daily menus were looked at too. A copy of the menu is available in the lounge and staff were heard asking people about choices for meals the following day. Menus do not include information about breakfast or supper. The details of each meal offered is brief and does not indicate that people always receive meals that are nutritionally balanced in line with current guidance. The home does not have a dining room. Gate-legged tables are used at mealtimes. Where people can manage chairs these are available otherwise people sit at the table in their wheelchairs. Comments were received from a visitor to the home about the tables. They thought that the tables were unsuitable for older people, especially if they have limited mobility. Some people could get to the table, but the legs and the middle parts of the table do cause some difficulties for people to sit comfortably for their meal. The service of the lunchtime meal was observed. Tables were laid nicely with napkins provided. People were offered choices. The food looked appetising and there seemed to be sufficient portion sizes. Staff were on hand to help people with their meal if needed. The staffing levels at lunchtime seemed a little low and staff were very busy serving meals and making sure that people who needed encouragement or assistance with eating, received attention. The cook was spoken to during the visit. The kitchen was clean and tidy and the cook was in the middle of preparing lunch. The cook said that she gets sufficient stocks to provide the meals on the menu. If she asks for extra things she gets them. ‘People are able to have what they like really. Some people have a full cooked breakfast, others have scrambled eggs or cereal and toast – there is a choice.’ Some staff are currently undertaking training on the subject of nutrition and this may help to make improvements to this important area of daily life. Green Lane House DS0000043390.V352372.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are generally protected from harm and abuse. There are some gaps, which need attention, to ensure that people are consistently protected. EVIDENCE: The home has a comprehensive policy and procedure in place in relation to complaints. Copies of the complaint process are on display in various places within the home including the entrance/reception area. The Statement of Purpose makes reference to the complaints process. This document should include full details of the process. People participating in the assessment of this service say that they are aware of how to make a complaint and to whom they should be directed. The manager is described as being very approachable. Most people indicated that although they had never needed to raise any concerns, they are confident that they would be listened to and their concerns dealt with appropriately. One person did feel that it would be ‘a waste of time asking’ for their request to be dealt with. Dealing with complaints and concerns is included in the staff induction training. This helps to ensure that where concerns are raised, staff are able to act appropriately. There are other opportunities for people living at the home to raise any concerns or issues that they may have, including the resident’s meetings. Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 15 The home has a policy and procedure to help ensure that people living at the home are safeguarded and protected from harm or abuse. A copy of the local authority’s safeguarding guidelines is also available at the home. Staff are provided with training in this important subject. There are some gaps in the staff recruitment process. For example records indicate that full information and checks are not always obtained prior to new staff commencing work. This potentially places people using this service at risk from harm. Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home generally provides a warm and comfortable environment for people using this service. EVIDENCE: The home is generally clean and tidy. There are communal lounges, which are comfortably furnished and warm. One of the smaller lounges is used as a quiet area and there is a public telephone available here. The laundry is kept in a clean, organised and tidy condition. The kitchen is compact, but is also clean, tidy and organised. The home does not have a designated dining room. Some issues have been raised about the arrangements in place for meal times, particularly about the style of dining tables used. The manager should give some consideration to these matters in order to make meal times more comfortable for some people using this service. People living at the home are able to personalise their own rooms with some of their possessions to help create a more homely environment. Many people Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 17 have their own TV and radio in their rooms. People are able to take their meals in their rooms if they wish. There are some areas of the home that are in need of redecoration and the manager says that there are plans to do some of this work over the next twelve months. Bathrooms and toilets are equipped with soap dispensers, paper towels and protective clothing. There are also aids and adaptations to help people access these facilities. However, the bathrooms are in need of some attention. Bath chairs are not very clean and the metal work under the chairs is rusty and corroding. There are other issues with the baths that need attention. Examples include a corroding plughole and another bath is badly scratched. These matters could compromise the control of infection. Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 18 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): Standards 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Areas of the recruitment process need to be improved to ensure that staff are properly checked prior to their employment. People living at the home must have their welfare properly safeguarded. EVIDENCE: During the visit to the home there appeared to be a sufficient number of staff on duty for most of the time. Staff did appear a bit stretched at lunchtime especially when helping and supporting people with eating their meals. People spoken to during the visit to this home indicate that staff are usually available when they need them and ‘come when I buzz for them’. The returned questionnaires also indicate that there are usually sufficient staff available. Many of the care workers at the home have obtained a National Vocational Qualification (NVQ) in Care at various levels. Records indicate that some staff have undertaken an approved induction training course. There are some gaps in these records, which may mean that the training has not been fully completed yet. Other staff records show that induction training has been completed in just one day. The topics recorded as covered have a significant amount of information for staff to understand and learn. It is unlikely that staff gain the depth of knowledge and understanding required. Staff say that they are provided with training that helps them in their role as care assistants. Their training includes the administration of medication, awareness of dementia care, manual handling, first aid and infection control. Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 19 There is no formal staff training and development plan in place at the home. There are some training records in place but there is no clear audit trail to check what training has been undertaken and when it is due for refresher. A sample of staff recruitment records was looked at during the visit to this service. Application forms are completed and some information is included regarding employment histories. This could be improved upon to make sure that any gaps are accounted for. Two references are requested, one being from the applicant’s last employer. Records show that references are not always obtained prior to the person commencing work at the home. Evidence was seen of Protection of Vulnerable Adult (POVA) checks being undertaken but Criminal Record Bureau (CRB) results were not available for inspection at the home. One staff file did not have either of these checks available. There are no formal arrangements in place to make sure that newly recruited staff are supervised and monitored as required, whilst waiting for the results of some of these checks to come through. This was discussed with the manager during the visit. Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 20 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): Standards 31, 33, 35, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is experience and well qualified to run the home, which is generally run in the best interests of the people who live there. EVIDENCE: The manager is skilled and experienced in providing care and managing a care home. She tries to keep her knowledge updated and has attended training courses and seminars including subjects such as infection control, health and safety, Mental Capacity Act and employment law. People participating in the assessment of this service are confident in the manager’s abilities and many describe her as ‘approachable and friendly’. Resident’s meetings are held to help gather the views of people living at this home. There is a policy in respect of resident’s finances. On the day of the visit to this service the home was not holding any money on behalf of residents. Residents Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 21 are encouraged to do this themselves or with the help of a family member, friend or social worker. A quality assurance programme is being developed at the home. People living at the home are able to attend residents meetings and there is a ‘suggestions box’ that can be used by residents and visitors to the home. Questionnaires are also used to obtain the views and opinions of people living at the home as part of the quality assurance system. This information will help the manager to bring about improvements to the home and the service. A sample of the fire records kept at the home was looked at. They confirmed that the fire fighting equipment is regularly serviced and that emergency lighting and the fire alarm is also tested frequently. The accident record book was also looked at. Records indicate that the home does not always report events that may adversely affect the well-being of people living at the home to the Commission for Social Care Inspection as required. Staff record show that they are formally supervised two or three times a year. There are no formal arrangements in place for the supervision of new staff. Staff supervision is an area that requires some attention to ensure that practice is monitored frequently and any training needs are identified. Infection control procedures are in place at the home and staff receive some training on this subject. Protective clothing is available for use by staff when necessary. Where infections have been present in the home, the manager has notified the Health Protection Agency and obtained help and advice. Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 22 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 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 OP2 Standard Regulation 14 Requirement Comprehensive care needs assessments must be undertaken or obtained prior to any person moving into the home. Care needs assessments help to make sure that the home is able to meet the needs, requirements and expectations of people considering moving into the home. People living at the home must have an individual and detailed plan of their health, care and support needs. The plans must be kept up to date and include details of the action that staff will take to meet the assessed needs of the person. People living at the home must have a nutritional assessment carried out. A record must be maintained and monitored frequently to help identify when further action or advice is required. Timescale for action 31/12/07 2 OP7 15 31/01/08 3 OP8 17 31/01/08 Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 24 4 OP9 13 Medication must only be given to residents from the container that the pharmacist or dispensing GP has provided. Re-packaging medicines into another container is called ‘secondary dispensing’. This is unsafe practice that can potentially cause drug errors. Individual medication administration records must be completed at the time the individual actually takes their medicines. Records must clearly indicate whether the medication has been taken or refused. People living at the home must receive a balanced and nutritious diet. Menus must be reviewed to reflect current guidance and best practice to provide a nutritionally balanced diet. You must ensure that risks to people living in the home are minimized as far as reasonable possible. Bathrooms and bathing equipment must be kept clean, hygienic and free of hazards at all times. You must ensure that a robust staff recruitment and selection process is always followed at the home. Staff (including volunteers) must not be appointed or confirmed in post until satisfactory checks (CRB and POVA) and references have been obtained, to safeguard the people using this service. You must ensure that persons working at the care home are appropriately supervised and have their care practices monitored on a frequent basis. DS0000043390.V352372.R01.S.doc 31/12/07 5 OP9 13 31/12/07 6 OP15 16 31/01/08 7 OP26 23 01/03/08 8 OP29 19 31/12/07 9 OP36 18 31/01/08 Green Lane House Version 5.2 Page 25 10 OP38 37 The Commission for Social Care Inspection is notified of any event, which adversely affects the well-being or safety of any person using this service. 31/12/07 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 2 Refer to Standard OP1 OP19 Good Practice Recommendations It is recommended that full details of the home’s complaints procedure is included in the Statement of Purpose and/or Service User Guide. A programme for the maintenance and renewal of the property should be developed. The programme should include details of the work and timescales for completion for all areas of the home requiring refurbishment and redecoration A staff training and development plan should be drawn up in line with national training targets. This will help ensure that staff working at the home have the skills necessary to fulfil the aims of the home and meet the changing needs of people using this service. 3 OP30 Green Lane House DS0000043390.V352372.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. 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