Inspection on 07/11/05 for Greenlands

This inspection was carried out on 7th November 2005.

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

Greenlands 19/09/07

Greenlands 05/12/06

Greenlands 25/04/06

Greenlands 10/05/05

Greenlands 24/01/05

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

CARE HOMES FOR OLDER PEOPLE Greenlands 46 Green Lane Bolton Lancashire BL3 2EF Lead Inspector Lucy Burgess Unannounced Inspection 7th November 2005 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 Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Greenlands Address 46 Green Lane Bolton Lancashire BL3 2EF 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) 01204 531691 Mrs Asma Ali Khan Mrs Shagufta Parveen Rasul Hussain Mrs Shagufta Parveen Rasul Hussain Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 10th May 2005 Date of last inspection Brief Description of the Service: Greenlands Residential Care Home was bought by the new owners Mrs Hussain and Mrs Khan, who took over the management of the home in December 2004. Greenlands is a private residential care home registered to provide care for up to 28 older people. The property is detached and set in its own well-maintained grounds. It is situated close to local amenities and accessible for local transport. The Home comprises of four single bedrooms and twelve double rooms. They are individually decorated and furnished and include a wash hand basin and a nurse call. There are no en-suite facilities. The Home offers the choice of two lounges and a separate dining room. The standard of cleanliness is good. There has been an ongoing programme of maintenance and re decoration to ensure a good standard is maintained. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over one day for a period of 9 hours. The inspector took the opportunity to look round the home, view records as well as talk with 3 residents, 5 staff and the visiting GP. Discussion and feedback was also held with the Owners/Manager. The home is registered to provide accommodation for 28 people. At the time of the visit there were 22 people living at the home. What the service does well: What has improved since the last inspection? The home have now taken on another cook who has experience of providing meals for a large number of people and has previously worked at the home. Daily diary sheets have now been put in place for each of the residents. Information shows what residents have done each day, if there have been any concerns, appointments or visits giving clear details, which enable staff to monitor the well being of the residents. The Manager has now commenced the NVQ level 4 management training needed, which she hopes to complete by the end of 2006. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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 Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 A detailed assessment needs to be undertaken before admission to the home, giving an assurance both to residents, relatives and staff, that a resident is only admitted if the home can meet their needs. EVIDENCE: An assessment was seen for the newest resident. This included a care needs assessment and risk assessment document, which had been forwarded by the funding authority. Information had also been noted by that the home as they had also visited the service user prior to admission to carry out there own assessment. Although comments had been recorded, this did not clearly detail how the decision had been made. The home should clearly evidence the assessment carried out in order to demonstrate that they are able to meet the needs of the service user. Assessment information is then used to inform the development of the care plan and risk assessment documents utilised within the home. The home does not accept placements for residents requiring intermediate services. Standard 6 does not apply. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8 Care plans and risk assessments are in place for each resident. Information does not fully reflect the support needs of the residents so that staff can satisfactorily meet the needs of residents ensuring the well being is maintained. EVIDENCE: Care Plans were seen for several residents. Information includes care plans, risk assessments, health professional’s involvement, personal care information, weight records and daily records. Plans also need to include what support external professionals i.e. the district nurse and mental health services provide. This should include the reason for the support and what is being provided. In relation to the newest resident, it was noted that the resident has a number of health care needs, which require regular monitoring and assessment. These included issues relating to falls, use of equipment, moving and handling, diet and swallowing, DVT, epilepsy and pressure care. This information had not been completed. A detailed care plan and risk assessments need to be developed ensuring the staff are fully informed in how to meet the needs of the Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 10 resident. It was noted that the resident had already had a fall, this must be monitored. Risk assessments were in place with regards to moving and handling, nutritional needs and pressure care. It was noted in one file that the assessments had not been completed in full therefore did not fully reflect the residents level of need. Accurate assessment must be completed ensuring where intervention from health professional is required this is identified. It was noted that individual diary sheets have been introduced for each of the residents and information is recorded with regards to individual routines, appointments, behaviour and incidents etc, providing a good tool for monitoring the well being of residents. From some records made it was found that several residents had been wandering at night or had increased agitation, however there was no further information to show that this had been followed up. This should be done. Records are also made of residents’ weight, however these had not been completed for October. It was also noted that 8 of the residents had not been weighed for several months as they were unable to weight bear. The manager must ensure that these individuals are monitored ensuring their dietary needs are maintained. Two residents were found to have lost 4lbs each in one month, this too needs to be followed up and information recorded on file evidencing what additional support or monitoring is taking place. On examination of the incident/accident book, 11 falls had been recorded during the period from September up to the time of the visit. Records found that 9 residents had been involved. The home must also monitor these incidents ensuring risk assessments are reviewed and interventions made where necessary. From observations made one resident became quite unsettled and was disturbing other residents with her outbursts. Staff explained that she would settle if she had several personal items with her, however it was found that these had not always routinely been given to her. The manager must ensure that this information is clearly detailed within the residents file and followed by the staff. Action must be taken with regards to reviewing the needs of this resident if there is no change in her behaviour ensuring needs are fully met. Care files are currently completed and updated by the deputy manager, however due to staffing difficulties and work priorities files had not been reviewed. The manager must ensure that sufficient undisturbed time must be provided to allow the deputy manager to work through the residents’ files ensuring the information and assessments in place fully reflect the needs of the residents. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 11 Residents generally appeared settled and relaxed. Comments received included ‘they’re lovely girls’, ‘I’m looked after’ and ‘we have a laugh’. Feedback received from the GP included, ‘feel the staff are very good’ and ‘will always contact and raise any concerns about the residents’. The medication system was not examined during this visit. The CSCI have recently received a complaint in relation to the safe administration and recording of residents’ medication. The CSCI pharmacist is investigating this. Co-operation is being made by the home. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 to 15 Activities are provided in and away from the home offering residents opportunities to socialise and access to the wider community. Links with family, friends and the community are encouraged as this provides more social opportunities and interactions. Food served appeared nutritious and varied. Alternative choices and available and special diets are catered for those who wish. EVIDENCE: Routines continue to be relaxed and based on individual preferences. Residents rise and retire to bed when they choose. From observations made the residents appeared relaxed and were able to express their needs. Activities are offered both in and away from the home, these include ‘sit me fit’ exercise, nail care, sing-a-long, name games, clothes and slipper party and films. A day trip had also taken place to Blackpool. Residents have also visited the local pub, gone for walks within the local community as well as accessing the local age concern day centre where they have had afternoon tea. One resident has recently spent time with family celebrating Eid as well as regularly attending a local day centre for Asian Elders. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 13 Whilst some residents enjoy the activities others prefer a more relaxed routine. Hours have been identified on the rota for one carer to facilitate activities during the afternoons. The home welcomes visitors to the home at any time. Relationships with family and friends are encouraged. The hairdresser and local clergy also visit residents. Menus have recently been reviewed offering alternative choices. Residents are asked which choice of meal they would like. The cook continues to make homemade cakes and deserts. Special diets are also catered for. Halal and vegetarian meals continue to be made available for one resident who follows a halal diet enabling her to follow her cultural and religious preferences. Food stores were found to be ample and included fresh, dry and frozen goods. Additional products are bought for those who have a diabetic diet. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Satisfactory arrangements are in place in relation to the protection of service users as well as responding to their concerns. Recent concerns have been raised, which are under investigation. Polices are in place outlining the appropriate response for allegations of abuse however training is still outstanding in this area. This must be provided ensuring the residents are protected. EVIDENCE: Clear policies and procedures are in place covering these standards. The complaints procedure is contained within the home’s Guide and available to service users and their relatives. The CSCI have recently received three anonymous complaints in relation to several areas relating to the environment and care practices within the home, these are currently being investigated and co-operation is being given by the home. A copy of the Local Authorities Vulnerable Adults procedure has been accessed. The team have some knowledge in relation to the procedure to follow however staff training in relation to Vulnerable Adults has yet to be undertaken by all staff so that they are fully aware of the action to take ensuring the safety of service users. The home has yet to develop a policy with regards to the management of service users finances and wills etc. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The home continues to provide pleasant accommodation to meet the needs of older people. Sufficient aids and adaptation have also been provided in order to meet the needs of the residents. EVIDENCE: Greenlands is a large detached property offering pleasant accommodation for the residents. The lounge and dining areas were clean and comfortably furnished. Residents make use of all areas. The home also provides a wellmaintained garden to the front and side of the home. The home continues to provide 12 double bedrooms and 4 single rooms. None of the bedrooms have en-suite facilities, however sinks are provided. Residents have personalised their room with belongings brought from home. Where residents have requested no locks or keys this has been recorded on their file. The home provides a number of communal toilets and bathrooms, which can be found on each floor. Rooms were clean and odour free. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 16 The home is equipped with suitable aids and adaptation to assist service users movement around the home. Handrails, grab rails, hoist, call bells and a passenger lift are available to offer support and aid mobility. Those service users needing support also have the provision of wheelchairs. The home has recently experienced difficulties with the passenger lift. Maintenance work has been completed however does not appear to have rectified the problem. The manager must ensure that this is addressed and that each floor is accessible to the residents ensuring their safety. It was also noted that a large number of the residents sat within the lounge area were covered by blankets. The owners have previously carried out work to the heating system and have planned further work ensuring the whole house is heated sufficiently. The manager must ensure that the home is adequately heated at all times and that blankets are only used on request. It was previously suggested that the fire officer be consulted with regards to the suitability of the door lock to the front door ensure easy access or exit can be made in the event of a fire, this has yet to be addressed. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 to 30 Sufficient staff was seen to be provided however must be monitored ensuring the needs of service users are met. Further training has been identified to provide staff with the knowledge and skills needed in meeting the needs of the residents. Information gathered for newly recruited staff was inadequate. Clear documentation is needed prior to staff or volunteers commencing employment so that residents are protected. Criminal Records Checks had been carried out. EVIDENCE: At the time of the visit the occupancy level was 22 residents. The home employs sufficient day and night carers to meet the needs of the residents. There are also additional staff employed to work in the kitchen as well as undertake domestic tasks. A second cook has recently been appointed. Based on the current occupancy levels sufficient staffing was found to be on duty however feedback received from staff was that at times this was insufficient due to the number of tasks that had to be carried out as well as ensuring that the residents were supported properly. The manager must ensure that adequate staffing are in place ensuring the needs of the residents are fully met. Where additional needs have been identified this should be reflected in the level of support provided. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 18 A number of staff were spoken with during the inspection, it was found that communication between staff and management was not as effective as it could be. Staff felt that they were unclear about what was expected of them. Clear roles and responsibilities need to be outlined so that staff are clear about their duties. Files were seen for the newest appointed staff. Checks had been carried out with regards to Criminal record Checks/POVA checks, these were seen on file. Further information required on new staff prior to starting their employment had not been carried out. All files must have 2 written references, a completed application form detailing a full employment history and photo. This information must be collated before commencing work at the home ensuring the safety and protection of vulnerable service users. Information was provided with regards to recent training. This included • 8 staff completed moving and handling, • 7 planned to complete 1st aid, • 2 staff had completed food hygiene, • 12 staff had completed adult awareness, • 9 staff had done medication, • 2 staff had done care of the dying. Further training was being explored with regards to fire safety. Additional updates must be provided in moving and handling ensuring all staff receive annual updates. Further training is still outstanding in infection control, continence care, adult awareness, dementia and food hygiene. These should be planned for the forthcoming year ensuring all staff attend courses relevant to their role and responsibilities including ancillary staff. Staff are also undertaking NVQ training. Nine carers are currently completing level 2. Four others have already achieved level 2, two of which have also gained level 3. The deputy manager has achieved level 2 and 3 and is currently completing level 4. The Manager has also commenced the level 4 training. New staff had not completed the Induction programme, which meets the TOPSS specification. This must be undertaken by all new staff within the first 6 weeks of employment and evidence placed on file, ensuring staff have been provided with the in formation needed in carrying out their role and responsibilities. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 35 and 38 A clear management structure and effective communication systems need to be developed between senior management and the staff team so that consistent staff support is offered ensuring the effective running of the home. Those residents requiring support with finances are assisted. Records are made of all transactions. Regular maintenance and safety checks need to be improved ensuring the safety of the residents and staff. EVIDENCE: Relationships between the Owners/Manager and staff are poor. Some members of staff continue to feel that where clear routines were in place this has changed and that at times they are not sure what they should be doing as communication from managers was at times conflicting. Morale continues to be low. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 20 Systems need to be developed with regards to formal supervision sessions, team meetings and managements meetings so that agreement can be made with regards to ways in which improvements can be made ensuring the effective running of the home and continuity of care for the residents. Comments received included; ‘I enjoy supporting the residents but feel we’re not trusted to do our job’ and ‘communication is poor’. Another comment made was that ‘staff are not always getting the leadership and support they need’. The manager has commenced the NVQ level 4 and Registered Managers course, this will be completed in 2006. Most of the residents’ money is managed by their families or designated representative. Records are made of all transactions. These have been developed however should include a signature by the person handling the money and where possible the resident. As residents’ money is not held within the home the owners have made arrangements for a separate residents bank account, which identifies the balance and any interest accrued. Certificates were seen for the electric, fire appliances, passenger lift, emergency lighting, small appliances and call bells. As already identified difficulties have been experienced with the heating and passenger lift, further maintenance work has been identified within standard 19. Records had been made in relation to water temperatures, however these had only been completed for September. Records showed that the temperature recorded for the bedrooms was 32oC and the bathrooms at 35oC. The manager must ensure that these are completed on a regular basis and the temperature is maintained at around 43oC. The general risk assessments were also due to be reviewed. These were generally reviewed and updated each March and September. The last dated recorded was March 2005. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 X 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 1 17 X 18 2 2 X X X X X X X STAFFING Standard No Score 27 2 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 1 X X 2 X X 2 Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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 OP3 Regulation 12 Requirement That were an assessment has been carried out detailed information is recorded evidencing the suitability of the placement. That plans fully reflect the current needs of the service users and are signed to evidence that they have been agreed by the service users or appropriate representative (previous timescale of 31 July 05 not met) That sufficient time is provided to allow for the development of individual care plans and risk assessments That information is fully recorded within the care plans of support offered from external professionals ie: CPN, district nurse and dietician (previous timescale of 31 July 2005 not met) That pressure care assessments clearly demonstrate how the scoring has been made and where intervention is required this too is documented (previous timescale of 31 July 05 not met) DS0000061961.V262921.R01.S.doc Timescale for action 31/12/05 2. OP7 15 31/01/06 3. OP7 15 31/12/05 4. OP8 15 31/01/06 5. OP8 13 31/01/06 Greenlands Version 5.0 Page 23 6. OP8 12 7. OP8 12 8. OP8 12 9. OP18 13 10. OP18 18 11. 12. OP19 OP19 23 23 13. OP29 19 14. OP30 18 15. OP30 18 16. OP32 12 That nutritional assessments and monitoring is carried out for each of the service users (previous timescale of 31 July 05 not met) That accurate records are made of individuals weights each month and where a loss has been recorded appropriate action is taken. (previous timescale of 31 July 05 not met) That service users are monitored in relation to falls and action taken to address any/all concerns. (previous timescale of 31 July 05 not met) That a policy is developed with regards to the management of service users finances including gifts and wills (previous timescale of 31 July 2005) That arrangements are made for all staff to complete training in relation to adult abuse (previous timescale of 31 August 2005) That action is taken ensuring the passenger lift is in full working order. That action is taken to the heating system ensuring the home is adequately heated throughout the day. That staff personnel files include all information as required under schedule 2 prior to commencing employment (previous timescale of 31 July 2005 not met) That all new staff complete the TOPSS induction on commencement of their employment. That training is provided in moving and handling, food hygiene, infection control, continence care and care of the dying. That communication between management and staff is improved and roles are clearly DS0000061961.V262921.R01.S.doc 31/01/06 31/01/06 31/01/06 31/01/06 31/01/06 31/12/05 31/12/05 31/12/05 31/12/05 31/03/06 31/12/05 Greenlands Version 5.0 Page 24 17. OP35 17 18. OP38 23 defined ensuring continuity of care. (previous timescale of 31 July 05 not met) That records in relation to service users are signed for following each transaction. (previous timescale of 31st July 2005 not met) That water temperature checks are carried out on a monthly basis and temperatures maintained at 43oC. 31/12/05 31/12/05 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. 3. 4. 5. Refer to Standard OP19 OP30 OP30 OP32 OP38 Good Practice Recommendations That advice is sought from the fire officer with regards to the suitability of the front door lock That staffing levels are reviewed ensuring the needs of the residents are fully met. That consideration is given to providing specific training in relation to the needs of the service users i.e. Dementia That regular team meetings are held to allow for open effective communication between management and staff and that information is recorded That the general risk assessments are reviewed and updated where necessary. Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 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 Greenlands DS0000061961.V262921.R01.S.doc Version 5.0 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. 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