Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Greenways 720 Preston Road Bamber Bridge Preston Lancashire PR5 8JP The quality rating for this care home is:
one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Marie Cordingley
Date: 1 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home
Name of care home: Address: Greenways 720 Preston Road Bamber Bridge Preston Lancashire PR5 8JP 01772339083 01772334633 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ark Care Services Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 30 Number of places (if applicable): Under 65 Over 65 30 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 30 Date of last inspection Brief description of the care home Greenways is a residential care home providing 24-hour personal care and accommodation for 30 older people. The home is owned by Mr and Mrs Ajisebutu, who also own a second home in the South of England. The home is located in a residential area on the outskirts of Bamber Bridge, close to all local amenities and the motorway network. The home is a two-story building. Accommodation is provided in single bedrooms, the majority of which have en-suite Care Homes for Older People
Page 4 of 30 Brief description of the care home facilities, comprising of a wash hand basin and WC. Although the rooms are pleasantly furnished, service users are also able to take personal possessions with them when they come to live at the home. Bedrooms are located on both the ground and first floor. There is a passenger lift. Accessible toilets and bathrooms are located on both floors near to bedrooms and living rooms. There are three dining areas; two of these are a combined lounge with a dining area. A separate conservatory is also available. The home is a no smoking home. The fees at the home range from £310.50 - £360 per week. There are additional charges for hairdressing and newspapers. All the above information and more can be obtained the Service User Guide which is available on request from the home. Care Homes for Older People Page 5 of 30 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating of this service is 1 star. This means that people using the service experience adequate quality outcomes. The inspection of this home included an unannounced site visit which was carried out over one day. As the visit was unannounced, the residents, staff and acting manager did not know it would be taking place until we arrived. Throughout the visit we held discussions with residents, staff and the acting manager and also viewed a selection of documents including residents care plans and staff personnel files. Care Homes for Older People
Page 6 of 30 As part of the inspection a case tracking exercise was carried out. This involved us looking very closely at the care of a small number of residents from the point they were admitted to the home. Prior to our visit we wrote to people who live and work at the home and asked them to take part in a written survey about all aspects of the service provided. We received a good response. We also asked the registered provider to complete a comprehensive self assessment document (AQAA) which covered all aspects of the service and its management. The AQAA was returned to us within agreed timescales and contained a good level of information. What the care home does well: What has improved since the last inspection? We made a number of requirements and recommendations following the last inspection and were able to determine that the majority of these had been addressed, although there were some still outstanding. The Service User Guide is an important document which is in place to help people Care Homes for Older People Page 8 of 30 make a decision about whether they want to move to the home. During the last inspection we found that some of the information in the guide was out of date and inaccurate. During this visit we found that the Service User Guide provided current and accurate information including recent changes in the management of the home. During this visit we were able to determine that care needs assessments had been carried out for all the residents who had been admitted since our last visit. These are very important because they help ensure that the home is the right one for the prospective resident and that their needs will be properly met. We found improvements in the way that residents care plans were organised. These improvements mean that information about individual residents is easier for care staff to access when they need it. A number of recommendations were made in relation to the management of residents medication following the last inspection. During this visit we were able to confirm that all these recommendations had been implemented. They included the completion of medication competence assessments for all staff on a regular basis and more careful monitoring of temperatures of fridges used to store peoples medicines. The provision of activities is an area that has improved since the last inspection. Discussion with residents and records viewed confirmed that there is now a wider variety of activities offered to residents on a more regular basis. One resident told us There is usually something going on that is very pleasant. There has been efforts to increase residents opportunities to enjoy trips out although it was found that residents would benefit from more frequent opportunities in this area. In line with a recommendation made following the last inspection, people are now able to choose from at least two options at every meal time. This means that residents have more opportunity to exercise choice in their daily lives. Since the last inspection there have been a number of improvements made to the environment. At the time of our visit one of the lounges had just been redecorated and new carpets and curtains purchased. The acting manager confirmed that the home now have a rolling programme of improvement in place to ensure that all areas are maintained to a good standard. Information from the registered provider confirmed that over half of the care staff at the home now hold National Vocational Qualifications in care at level 2 or above. In addition, all carers who havent obtained the qualification are currently working towards it. What they could do better: Pre admission assessments are carried out for all residents but some examples we viewed contained very brief information and didnt tell us a lot about the individual. In addition, we didnt see evidence that people had been given the opportunity to express their views and opinions about how they wanted their care to be provided. We talked to the acting manager about this and recommended that the process be reviewed to ensure it is carried out in a more individualised and person centred way. Care Homes for Older People Page 9 of 30 We found that there had been some improvements to residents care plans but still noted some examples where information in care plans did not consistently reflect peoples needs. However, in discussion carers showed good understanding of residents individual care needs and the action required to ensure their needs were met. As such, we were satisfied that the problem was in the record keeping as opposed to a failure to provide appropriate care. We talked to the acting manager about how gaps in peoples care plans could potentially lead to gaps in their care and made a requirement in relation to the matter. Since the last inspection the home have improved the provision of activities and we found that people were now offered more choice in how to spend their time. However, we made some recommendations to further develop this area including an increase in one to one activities for those people who preferred them and more opportunities for residents to take part in trips out of the home. We found problems with the temperature of water in some residents bedrooms. Some peoples water took a very long time to heat up and in one case it didnt heat up at all. This was pointed out to the acting manager during our visit and we have made a requirement in relation to the matter. We consulted staff during our visit and prior to our visit in writing. All the staff we spoke with were very complimentary about the training provided and said that they felt they were provided with an appropriate amount of training to carry out their roles well. However, records were not available at the time of the inspection to confirm exactly what training each staff member had received. We advised the acting manager to develop a training matrix and keep this in the home at all times. Having the information close at hand will enable her to monitor training and ensure people receive updates at the appropriate intervals. We were concerned to find that there was no fire risk assessment available at the home during our visit. We were advised by the registered provider that one had been completed but that it was kept at the head office of the provider. We have made a requirement that the document be maintained in the home at all times so that people living and working there have access to it at all times. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 30 Details of our findings
Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 30 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with the information they need to help them make an informed choice about moving to the home. A more person centred assessment process would assist carers in providing care tailored to the individual. Evidence: The home provides a Service User Guide to anyone who expresses an interest in moving there. This is a useful document which includes information such as facilities available and fees. It also gives the reader a picture of daily life at the home describing arrangements for areas such as mealtimes and activities. We were able to confirm that the Service User Guide is made available in a number of formats including large print. In addition, the acting manager advised us that the guide would soon be available in an audio format. Care Homes for Older People Page 12 of 30 Evidence: We viewed the Service User Guide and found that it had been updated to include details of recent changes in the management of the home. As part of our case tracking exercise we looked at a number of residents pre admission assessments. We found that in general, the assessments addressed peoples daily care needs but didnt really say much about the individual. There were no examples of people being asked for their views on how they would like their care to be provided and very little information about peoples social histories or preferences in relation to social areas such as activities and hobbies. We discussed pre admission assessments with the acting manager and advised that more time be spent ensuring that the admission process is carried out in a more person centred and individualised manner. Care Homes for Older People Page 13 of 30 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care plans do not always fully reflect their needs. This could lead to gaps in their care. Evidence: As part of our case tracking exercise we looked at several residents care plans. We found that in general they contained an adequate amount of information about peoples daily care needs but in some examples there was information missing. For example, we tracked the care of one resident who had, according to her daily update notes, experienced some episodes of anxiety. There was no reference to this in her care plan and no guidance to staff in how to support her in this area. Another resident we case tracked was at high risk of developing pressure sores but there was no risk assessment or pressure care plan in place. However, when we talked to carers they showed awareness of the measures they needed to take to prevent the resident from developing pressure sores and we were also able to confirm that the residents skin was healthy in all areas. As such, we were satisfied that the problem was in the
Care Homes for Older People Page 14 of 30 Evidence: record keeping and not about failure to actually provide care. The sample of daily care records viewed demonstrated that carers monitor residents health carefully and are quick to ensure that people receive support from relevant health care professionals. We found evidence of effective joint working with a variety of health care professionals including district nurses, doctors and specialists. In some examples we didnt find any evidence that people had been involved in their own care planning. We spoke with one resident who clearly wanted to contribute to the development of her care plan but said that she had not been given the opportunity to do so. We talked to the acting manager about this and advised her that every effort should be made to enable residents and their representatives to contribute to the development of their plans. The home have good systems in place for the safe receipt, storage, administration and disposal of peoples medication. We viewed a number of records relating to medication and found these to be in good order and well maintained. We also noted that medicines were stored, safely and securely. Following the homes last inspection we made some recommendations about how systems could be improved and during this visit we were able to confirm that these recommendations had been implemented. They included carrying out recorded and regular competence assessments of all staff who deal with medication to ensure that they are working safely. . Care Homes for Older People Page 15 of 30 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are regular opportunities for people to take part in enjoyable activities but some people would benefit from more one to one opportunities. Evidence: We talked to people about daily life at the home and in general, people told us they were happy with arrangements in areas such as activities and meals. One resident told us There is usually something going on. We do some quite pleasant things. Each persons care plan we viewed contained a record of activities they had taken part in and these showed that a variety of activities are offered on a daily basis including arts and crafts, quizzes and games for example. In addition, the home employs visiting musicians to entertain residents on a regular basis. We also noted that there had been an increase in trips out and that some residents had enjoyed outings to places such as Blackpool in recent months. In discussion, the acting manager told us that this was an area that the home were looking to develop further and one resident commented I would like the chance to go on more outings, they are few and far between at the moment.
Care Homes for Older People Page 16 of 30 Evidence: Some records of activities we viewed showed that there were residents at the home who often chose not to take part in group activities. However, there were no references to this in their care plan and we couldnt find any evidence of one to one activities being offered to these people on a regular basis. We talked to the manager about this and advised that the activities programme be reviewed to ensure that it is person centred and in line with peoples individual preferences. Most people we spoke with said that they enjoyed the food at the home. One resident said I have no complaints at all, it is always very good. However, one person commented that the quality of food varied at times. Menus showed that people are offered a varied and nutritious diet at the home. We were also able to confirm that people are provided with a choice of main course on a daily basis, in line with a recommendation made following the homes last inspection. We were advised that the cook speaks with each resident individually on a daily basis to discuss the options available and record their choices for the day. During our visit we joined residents for lunch. The meal served was nicely presented and of a good standard. We also noticed that the mealtime was relaxed and that people were able to enjoy their meal at their own pace. We observed some residents being provided with assistance to eat and this was done in a discrete and dignified manner. We did note the absence of condiments and other items such as serviettes during the meal. One resident was observed having to go to the kitchen to request a serviette. We talked to the acting manager about this and asked her to ensure that tables were set appropriately so that residents had everything they needed. Care Homes for Older People Page 17 of 30 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to ensure that any concerns raised are dealt with quickly and thoroughly. Evidence: The home has a complaints procedure in place which is clearly written and easy to understand. We viewed the procedure and found that it contained all the appropriate information required and contact details of relevant people. In discussion, the acting manager advised us that the procedure has now been made available in large print. In addition, we were advised that work was ongoing to make the procedure available in other formats such as audio, so that everyone has equal access to the information. The home keeps a record of all complaints or concerns raised. We viewed this and found that all complaints made since the last inspection had been dealt with appropriately and in a timely fashion. We made a recommendation that the record be maintained in a book as opposed to its current loose leaf folder design, to ensure that information is not lost. The acting manager and staff we consulted showed a good understanding of Safeguarding procedures. Carers were aware of whislteblowing procedures and told us
Care Homes for Older People Page 18 of 30 Evidence: that they felt confident that any reports of abuse or bad practice would be dealt with appropriately. We were advised by the acting manager that all carers are provided with training in Safeguarding at the start of their employment. This was also confirmed by staff we consulted. In answer to our survey one staff member wrote My induction covered a lot of things about preventing abuse and the importance of reporting anything of concern that you witness straight away. Care Homes for Older People Page 19 of 30 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with comfortable, homely accommodation but it must be ensured that they have access to appropriate facilities such as hot water at all times. Evidence: We carried out a tour of the home and found all areas to be warm, comfortable and clean. The home is generally well maintained and nicely furnished. We noted that there had been some improvements made within the home including the redecoration of one of the lounges. The acting manager advised us that there is a rolling programme in place to ensure that all areas are maintained to a good standard. We viewed several residents bedrooms and found that these were nicely personalised with items such as pictures and ornaments and in some cases, residents had pieces of their own furniture in their rooms to make them feel at home. The home employs a maintenance man who works on a full time basis. This means that any issues requiring attention can be dealt with quickly. We tested the water in some areas and found that the water in some residents bedrooms took a very long time to warm up and in one case did not warm up at all
Care Homes for Older People Page 20 of 30 Evidence: despite us waiting for several minutes. We pointed this out to the acting manager and asked her to ensure that this was addressed as soon as possible. There are a number of showering facilities in the home but at the time of our visit there was only one bathing facility and this was out of use. We were advised that the home were in the process of addressing this. There are procedures in place to protect people from infectious diseases and staff we consulted showed a good understanding of these. The acting manager confirmed that infection control training was provided to all staff as part of their induction training. Care Homes for Older People Page 21 of 30 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Careful recruitment procedures help keep people living at the home safe. Evidence: Discussions with the acting manager and staff confirmed that the home follow careful processes to ensure that only suitable people are employed to work there. The acting manager advised us that all prospective staff members are required to complete a detailed application form which includes a full employment history. We were also able to confirm that any gaps in a candidates employment history are fully investigated and a record kept of the explanation provided. Records viewed confirmed that appropriate background checks are carried out for people before they start work including references and a Criminal Records Bureau check. One staff member who responded to our written survey wrote I wasnt able to even start before they had checked my police records and previous employment. During our visit we noted that staffing levels appeared to be appropriate to meet the needs of people living at the home. Carers were observed spending time with residents and providing care in a relaxed and unhurried manner. People we consulted told us that they felt staffing levels were adequate. One staff member wrote There is a good
Care Homes for Older People Page 22 of 30 Evidence: staff to resident ratio which is always improving. Records viewed confirmed that all new starters are provided with an in depth induction which is in line with Skills for Care standards. In addition, the home have a mentoring system so that new staff members always have a point of contact that they can use if they need advice or guidance. Staff who responded to our written survey were very complimentary about the standard of training provided and all told us that they felt they were provided with appropriate training to carry out their roles well. However, at the time of our inspection there were no records available to confirm exactly what training each staff member had done. We advised the acting manager to develop a training matrix so that this information was available within the home at all times. We were advised by the registered provider of the home that over 60 per cent of staff have completed National Vocational Qualifications in care at level 2 or above and that the remaining 40 per cent were in the process of completing the training. The registered provider told us that plans were in place to ensure that all staff hold the qualification in the near future. Staff members we consulted told us that they felt well supported by the management of the home. One carer wrote I always feel like I can approach Gill (the acting manager). another said I work in a friendly, happy atmosphere which is good for the residents. Care Homes for Older People Page 23 of 30 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Current management arrangements are sufficient to keep people safe but there needs to be a registered manager in place to ensure that home is consistently well managed. Evidence: The home has been without a registered manager for a considerable length of time. However, there was an acting manager in place at the time or our inspection who demonstrated that she had the appropriate skills and knowledge to manage the home effectively. In addition the acting manager explained that the registered provider visited the home on a regular basis and was always available to provide guidance and support. People we consulted told us that the acting manager was very supportive and approachable. One resident said She is always about and very helpful. A staff member told us Staff morale is at an all time high because we feel that everything we do is always appreciated.
Care Homes for Older People Page 24 of 30 Evidence: The registered provider of the home monitors quality in a number of ways including carrying out regular satisfaction surveys with residents, their relatives and other stakeholders. When viewing the Service User Guide we were able to confirm that results of such surveys are published within it for peoples information. In addition, the home benefits from an external quality assurance programme which results in additional inspections of all aspects of the service on a regular basis. There is a health and safety policy in place which is supported by a number of procedures including infection control and coshh (control of substances hazardous to health). Staff we consulted told us that they received adequate health and safety training but their were no records available to confirm this. We discussed this with the acting manager and advised her to ensure that these records are available at all times, to confirm that the training has been provided and also to help her ensure that people are provided with refresher training at appropriate intervals. During our visit we asked to see the homes fire risk assessment. The acting manager was unable to provide this. We spoke with the registered provider who advised us that there was a fire risk assessment but that this was currently kept at the providers office. We made a requirement that the fire risk assessment be available within the home at all times. Care Homes for Older People Page 25 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 31 8 (1) (a) A suitably qualified and 30/09/2008 experienced manager must be registered with the Commission in respect of the home. A fire risk assessment must 31/05/2008 be completed and made available to all residents, staff and visitors at all times. (Previous timescale of 31/01/08 and 31/05/2008 not fully met). 2 38 23 (4) (a) Care Homes for Older People Page 26 of 30 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 15 Residents care plans must contain an accurate and up to date account of all their daily care needs. This is so that carers have all the information they need to provide the right support. 31/03/2009 2 8 13 Risk assessments must be 31/03/2009 completed for all residents in relation to developing pressure sores and falling. This is so that carers have the information they need to work with people safely. 3 21 23 Adequate bathing facilities must be provided for residents at all times. This is so that people have access to appropriate facilities at all times. 30/04/2009 4 25 23 It must be ensured that the temperature of hot water in all areas of the home is suitable. 31/03/2009 Care Homes for Older People Page 27 of 30 This is so that people have access to hot water whenever they require it. 5 31 8 A suitably qualified and experienced manager must be proposed to the Commission for registration. This is so the home benefits from consistent and effective management. 6 38 23 The homes fire risk 31/03/2009 assessment must be kept within the home at all times. This is so that people have access to the information within it at all times. 7 38 18 All staff must be provided with appropriate training in the key health and safety areas. This is to ensure that staff have the necessary knowledge and skills to work with people in a safe manner. 30/04/2009 30/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 3 Peoples assessments should be more person centred and include the persons own views on how they would like their care to be provided. It is strongly recommended that care planning systems be reviewed to ensure that residents and where relevant, their representatives can be fully involved in the completion of their care plans. 2 7 Care Homes for Older People Page 28 of 30 3 7 Where people have needs in relation to their behaviour, the area should be adressed in their care plan. This is so that carers have enough information to work with people in a consistent and confident manner. The area of activities should be reviewed to ensure that people who prefer not to take part in group activities are offered opportunities to carry out activities on a smaller scale. The complaints record should be maintained in a book as opposed to a loose leaf folder so that information is not lost. All residents should be offered a lockable room and key unless a risk assessment determines that this would be unsafe. A training matrix should be developed and kept within the home at all times. This is so that the manager can ensure that all staff are provided with the appropriate training and refresher training at appropriate intervals. Meetings for residents and their relatives should be held on a regular basis. 4 12 5 16 6 19 7 30 8 33 Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
