Inspection on 14/11/06 for Guild House

This inspection was carried out on 14th November 2006.

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

Guild House 10/02/09

Guild House 13/02/08

Guild House 09/10/07

Guild House 07/12/05

Guild House 29/06/05

Guild House 09/02/05

Guild House 21/09/04

Guild House 24/03/04

Guild House 30/12/03

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

CARE HOMES FOR OLDER PEOPLE Guild House 2a Denmark Road Gloucester Glos GL1 3HW Lead Inspector Mrs Eleanor Fox Key Unannounced Inspection 14th November 2006 09:45 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 Guild House DS0000016453.V314744.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. Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Guild House Address 2a Denmark Road Gloucester Glos GL1 3HW 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) 01452 525098 01452 380245 The Gloucester Charities Trust Miss Moya Doreen Neighbour Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. When two people wish to occupy room 12 they are offered an additional single bedroom, which they can use as a sitting room if they wish. 7th December 2005 Date of last inspection Brief Description of the Service: Guild House has undergone a major refurbishment over the last few years. The original home has been extended and enlarged to include an additional second floor. Communal areas are spacious and doorways provide adequate space to accommodate wheelchair users. The communal rooms consist of a large dining room, one intimate lounge and a large lounge/conservatory on the ground floor. There are also further seating areas on each landing, which provide quiet places to relax. The accommodation consists of forty-one spacious single bedrooms on three floors. Couples who wish to share can also be accommodated. All rooms have a large en-suite with either a bath or a shower. Each floor also has an assisted communal bathroom. There are assisted communal toilets on the ground floor. Each floor has a small kitchenette for the residents’ use. All floors can be accessed by the passenger lift. The home has a new call bell system and security facilities. The property is furnished to a high standard and has many homely features to enhance the environment. There is level access to the attractive garden area. Guild House is approximately one mile from the city centre. Buses pass nearby to both the city and to Cheltenham. A church is next to the home and a small park is within walking distance. The provider supplies information about the home, including access to the most recent CSCI report to anyone who has expressed an interest. The details are maintained in a file, which is displayed in the front hall of the home. Current fees range from £409 to £526 (a double room). Some personal items are charged extra; the individual prices are available in the home. Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the home and takes into account the views and experiences of people using the service. One inspector undertook this unannounced inspection of Guild House over two days in November 2006. During the visit, she chose the care of four of the residents for particular scrutiny. She met each of these people, read their care records including medication administration documents, visited their bedrooms during a full tour of the property and, where possible, observed their interaction with members of staff. The inspector read selected personnel and recruitment records, observed the service of a mid day meal and joined a large group of residents for more general conversation during her visit. She also spoke with some of the staff who were on duty on these days. Finally, she had the opportunity to talk to the Manager, Care Coordinator and the Administrator, particularly in relation to general management issues. All were open and most cooperative in providing information as requested. CSCI surveys were distributed to residents, relatives and members of staff working at the home. 16 were returned from residents; 7 completed surveys were received from staff and 18 comment cards were sent in from relatives and advocates. Many of their comments and opinions are reflected in the content of this report. What the service does well: All residents admitted to the home are subject to rigorous assessment processes to ensure that the home is able to meet their needs. Staff employed at Guild House are friendly and welcoming to anyone visiting the home. They have also developed good working relationships with the residents living there, treating them with respect and kindness. A varied programme of activities is arranged for the residents; these events are much appreciated and enjoyed by the majority of the people living at this home. A good standard and variety of food is served in this home. Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 6 Residents are accommodated in most attractive and comfortable surroundings; the furniture and furnishings have been chosen to suit the needs and preferences of the people living in the home. What has improved since the last inspection? 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. Guild House DS0000016453.V314744.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 Guild House DS0000016453.V314744.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A comprehensive assessment process plus the provision of some literature about the home enables prospective residents to make an informed decision regarding their admission and gives them assurance that their needs will be met. EVIDENCE: The Home’s Statement of Purpose and Service User Guide have both been fully reviewed and updated to reflect the current situation at Guild House. Copies are provided to each resident and are also available in the front hall of the home for anyone who wishes to read them. A draft contract outlining the terms and conditions for admission to the home was shown to the inspector. However a copy of this document had not yet been provided to any of the residents who were selected as part of a case tracking exercise during the inspection of the home. Each person had been Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 9 provided with clear details about the charges for services provided at Guild House. Full assessments are undertaken of each prospective resident; completed records relating to these visits were seen in the care records. It was evident that a very comprehensive assessment is undertaken to ensure that the home is able to meet the prospective resident’s needs. The Manager and a senior member of staff normally take responsibility for undertaking these processes. Members of staff employed at the home receive training to provide personal care to the people living there. If a resident’s condition changes significantly after admission, reviews are undertaken if it is considered that Guild House is no longer able to meet this person’s needs. One resident who now required full time nursing was being transferred to a nearby home on the day of the inspection; another had recently been transferred to a home, which was registered to care for people with mental health related illnesses. When possible prospective residents spend a few hours in the home to meet everyone there and to see all the facilities prior to their admission. One person had initially come for a short respite stay but was now living permanently at Guild House. The relative of one person was shown around the home during the inspection. A current resident said, “I was given a full tour of the building and I was given all the information I needed. The staff were very welcoming.” Intermediate care is not provided at this home. Guild House DS0000016453.V314744.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The care planning systems in place do not fully provide the staff with the information they require to care for all the residents’ needs. However residents do receive the care they require. Improvements are also required in the management of medication systems to ensure that residents are not put at any risk of potential errors. Residents are treated with courtesy and respect. EVIDENCE: Since the last inspection, new care planning documentation has been introduced at the home; the staff have also received formal training on the subject. The care records relating to the four selected residents were read in detail on this visit. Very thorough initial assessments are completed. These include details about the person’s personal profile, social and leisure interests, physical health, mental health, personal risk assessment, moving and handling assessment, behaviour assessment, pressure sore assessment, nutrition screening Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 11 assessment, falls risk assessment, specific needs and preferences. A second document is then completed to record day-to-day care. Once the initial records had been completed, there was limited evidence that these had been subject to review and in three examples seen on this occasion no longer reflected the resident’s current condition. One person now required treatment from a district nurse to address a pressure sore; another had developed swallowing difficulties and also required specific mouth care; a third person had developed mobility problems. In each case, the resident was actually receiving appropriate care but this was not reflected in the documentation. There are forms to be completed if residents have been given personal care. According to the record, one person had not had a bath or shower since August; another had had no care in September or November. However discussions with both people showed that this was clearly not the case; both were receiving consistent and appropriate care. Any visits from medical and care personnel are documented, as is any advice or instructions provided. A District Nurse and a General Practitioner both visited the home to attend to residents during the inspection. The requirements identified following the CSCI pharmacist inspection in January 2006 were checked on this visit. Certification was provided to show that senior staff have attended formal medication administration training; improved medication storage has also been arranged. Photographs were now provided for each person to aid identification and risk assessments introduced for residents who wished to take responsibility for their own medications. However, in the examples seen on this occasion, handwritten entries on the medication sheets were not always signed by the responsible person or countersigned by a second witness. There were also no written care plans to guide staff when medications were prescribed as, “as required”. Carers who were questioned were unaware of any alterations to the medication administration policies and procedures. Throughout both days of the inspection, members of staff were observed and overheard addressing the residents in a respectful but friendly and encouraging fashion. All personal care appeared to be given behind closed doors. Carers were also observed knocking on doors prior to entering bedrooms. One relative wrote, “All the staff are friendly and treat Mum with respect” and a resident commented that, “The staff are always willing to help. They never make me feel a nuisance”. Guild House DS0000016453.V314744.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Good opportunities are provided for varied and stimulating activities to occupy the residents and thus improve their quality of life. Residents are facilitated to maintain any links they wish with family, friends and the local community, thus adding interest to their lives through social contact. The meals are nutritious and balanced, offering good variety to the residents. EVIDENCE: An activities organiser plus a part time assistant have been employed at the home in recent months. Together they arrange a good variety of activities to suit the particular interests of the people living at Guild House, including those with poor memory and limited communication. On the day of the inspection twelve of the residents were preparing decorations to sell at a forthcoming Christmas Fare. During conversation, residents confirmed that they are able to get up and retire when they wished and to spend their days how they would like, within Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 13 their own capabilities. Those people who did not wish to be involved in group activities pursued their own particular interests in their bedrooms or in one of the alternative communal rooms. Family and friends are welcome to visit whenever the resident wishes. Families are invited to attend special events when they are arranged at the home. Without exception, all those who responded to the questionnaires were most supportive of the home. One person wrote, “We are completely satisfied with all aspects of Guild House. The staff are wonderful and my Mother is settled and happy there.” Another wrote, “It is a welcoming place and absolutely smell-less!” Residents were observed exercising choice in a variety of ways particularly in relation to their food, whether to be involved in the planned activity and one person chose not to have a bath on the morning of the inspection. Advice on how to source advocacy, if required, is displayed prominently in the home. Residents’ signatures on care records showed that they had had sight of and input into care plans, which had been written about them. The service of the mid day meal was observed on this visit. The majority of residents sat in the spacious comfortable dining room with a few preferring to remain in their bedrooms. They were provided with a good choice of food and those residents requiring assistance to eat their food were helped in a patient and sensitive manner. Every resident who was questioned spoke most favourably about the meals with one person commenting that, “The food is very good here, I really enjoy it.” Another said, “The cook gives us good food; just what I like”. The kitchen was clean and tidy. However it is recommended that ‘out of date’ and shabby notices displayed in the dining room and just outside in the corridor, should be removed to improve the ambience of what is otherwise an attractive area. Guild House DS0000016453.V314744.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. A satisfactory complaints system enables residents and their families to feel assured that their views would be listened to and acted upon. Staff training and written guidance is required to ensure that residents are offered a good level of protection against abuse. EVIDENCE: The home has developed a Complaints Procedure, the details of which are provided in the front hall of the home and in the Service User Guide. No formal complaints have been received in the home in recent months but arrangements are in place to record these if necessary. A resident wrote in the questionnaire, “I just tell the staff if I have any concerns. Everyone is so helpful, I rarely have any problems.” The Manager is currently reviewing policies and procedures, including those relating to abuse issues. She is planning to provide handbooks to each member of staff; these give good advice and guidance on these subjects. Although abuse is addressed during National Vocational training, the remaining staff employed at Guild House have not received recent training on this important subject. This must now be rectified. Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents are provided with a very good standard of clean comfortable accommodation. EVIDENCE: During a walk around the building, it was observed that the whole home was clean and fresh. The entire property was well decorated and furnished to a good standard. ‘Evac’ chairs have just been provided on each landing of the home; these have been installed for staff use in the event of a fire at Guild House . All the communal rooms are furnished with sturdy comfortable chairs; a large wide screened television is provided in the large conservatory on the ground floor. A ‘quiet room’ has recently been created on the ground floor where residents may read or sit peacefully. Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 16 A visit was made to the bedroom of each person who had been selected for case tracking. All the rooms had been personalised with photographs and treasured possessions. Each had the benefit of spacious en suite facilities. However, the chest of drawers in one bathroom was broken and could have represented a health and safety risk to the resident or anyone using it. This issue was identified to the manager for attention. The laundry room was tidy and well organised; dedicated staff take responsibility for laundry duties; members of staff observe strict infection control protocols. It was noted that residents’ personal clothing was ironed prior to return to each person’s bedroom. Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents receive care from a stable competent workforce but improved recruitment and training opportunities would help to ensure residents are fully protected. EVIDENCE: On the first day of the inspection there were thirty-nine residents living in the home. The Manager and the Care Coordinator were on duty with seven carers to look after the residents. Four cleaners, the administrator, the cook and kitchen assistant were also working that day. Four carers were scheduled to be on duty in the evening with three carers working overnight. The shift working patterns have been reviewed and amended slightly to meet the changing needs of the home. The majority of people who responded to the questionnaires felt that there was normally an adequate number of staff on duty to care for the residents although there were a few isolated comments that the home is sometimes short of staff. Of the thirty care staff employed at the home, twelve have achieved a National Vocational Qualification, (NVQ) Level 2 in Care and a further three people, an NVQ, Level 3 in Care. Six carers are undertaking NVQ training at the current time and others have made a commitment to commence the course. The home is now achieving the standard that at least 50 of care staff should be trained to NVQ, Level 2 or equivalent. Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 18 Personnel files relating to the four staff employed since the last inspection were read in detail. In each instance, the prospective employee had completed an application form providing details of his or her employment history; however records had not been made of the interview processes and there were no staff photographs on file. Correct POVA (Protection of Vulnerable Adults) and CRB (Criminal Record Bureau) screening had been completed for each person. Two written references had been provided for the majority of applicants but in one case, two written references had not been obtained prior to the commencement of employment, as is required. There was also no evidence that two new employees had undertaken any form of formal induction. These anomalies were identified for urgent attention. The systems for recording attendance at training courses are being upgraded at the current time. As a result it was difficult to determine staff attendance at any training during 2006. However it was acknowledged that the majority of staff required updating in manual handling. The staff have not received any recent training on abuse issues or caring for people with dementia care needs. However some employees have attended training on care planning this year. Training needs are now being addressed in the home. Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. There are management systems in place to ensure that the financial interests, and the health, safety and welfare of people using the service are safeguarded; some minor improvements would be of benefit to the home. EVIDENCE: Since the last inspection of Guild House, the Manager has been interviewed and registered by the Commission for Social Care Inspection. This lady has extensive experience in the care of elderly people and is now introducing a variety of management improvements at the home. Responses to the questionnaires show that she is well respected by the residents and staff working at the home. Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 20 There are only limited quality assurance processes in place at the current time although a questionnaire has been prepared for the residents, which will be circulated shortly. Residents’ meetings are arranged regularly and minutes shown to the inspector described how residents’ views and requests are sought and, where possible, acted upon. Senior staff are monitoring the new care planning systems but medication administration systems would also benefit from closer supervision. Residents’ responses to the CSCI surveys show that, in the main, they are satisfied with the care they receive. The administrator looks after the personal monies for many of the residents. These are kept in individual envelopes and are locked away securely. All transactions are fully documented and countersigned. Checks of the files relating to the four residents selected for case tracking showed that these are all recorded accurately. Each resident’s status in relation to ‘Power of Attorney’ is also maintained on file. Records were provided to show that statutory maintenance/inspection of equipment and services is arranged in a timely fashion. Where faults are identified, these are rectified as necessary. Water temperatures are not yet checked at outlets on a monthly basis; this practice should now be introduced. The home was also not able to demonstrate that the hot water systems have been tested for Legionella. A Fire Risk Assessment was undertaken in 2005. However there were no recent records to show that members of staff had attended fire training in the home. An external specialist has just undertaken a full risk assessment of Health and Safety issues and the identified concerns will now be addressed. Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 2 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 1 3 4 x x x 2 x 3 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 1 x 3 x x 2 Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP2 Regulation 5(1c) Requirement Each resident must be provided with a copy of the terms and conditions for admission to the home. The registered persons must ensure that all care plans are detailed and regularly reviewed after consultation with service users or their representative. This is particularly in relation to pressure area care, nutritional and oral care and mobility assessments. (This requirement has been repeated from the last inspection.) The registered persons must review and update the medicine policy and procedures with the guidelines from the Royal Pharmaceutical Society and advice provided in the pharmacist’s report and at his inspection in January. (This requirement has been repeated from the last inspection.) The revised information must be circulated to the staff in the home. DS0000016453.V314744.R01.S.doc Timescale for action 31/01/07 2. OP7 15 31/12/07 3. OP9 13 31/12/07 Guild House Version 5.2 Page 23 4 OP9 13, 15 & 17 The registered person must ensure that all residents have written plans describing the use of any medicine prescribed ‘as required’ and that where relevant, care plans contain information about the management of a resident’s medical condition. (This requirement has been repeated from the last inspection.) The registered persons must ensure that MAR charts are always complete and accurate and in particular that a) handwritten entries are signed by the responsible person with a second competent person signing to confirm details are correct; b) the actual dose administered is noted where a variable dose is prescribed; c) reasons for doses not being given are fully defined. (This requirement has been repeated from the last inspection.) The registered persons must ensure the policy for protection of vulnerable adults from abuse is clear and comprehensive. (This requirement has been repeated from the last two inspections.) Staff must receive training on abuse issues. Repairs must be made to the broken furniture identified during the inspection Two written references must be provided for each prospective employee. A recent photograph must be provided of the applicant. A record must be maintained of DS0000016453.V314744.R01.S.doc 31/12/07 5. OP9 13 & 17 31/12/07 6. OP18 13.6 31/12/07 7 8. 9 OP18 OP24 OP29 18 (1c) 23 (2b) Schedule 2. (1), 3 (18) (1 ci) Schedule 28/02/07 31/12/07 31/12/06 10 OP29 31/12/06 Page 24 Guild House Version 5.2 4.6g 11. OP33 24 the induction processes. The registered persons must introduce a comprehensive quality assurance system. (This requirement has been repeated from the last inspection.) The home must demonstrate that the hot water systems are free from Legionella. Evidence must be provided that fire drills are arranged at the home and that staff are adequately trained in fire prevention techniques. 31/12/06 12 OP38 13(3 & 4) 28/02/07 13 OP38 23(4e) 31/12/06 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. Refer to Standard OP9 OP9 OP15 Good Practice Recommendations The March 2006 edition of the British National Formulary should be provided for staff reference. An ongoing list of sample signatures and initials of staff who are authorised to handle medicines should be kept. It is recommended that ‘out of date’ and shabby notices displayed in the dining room and just outside in the corridor, should be removed to improve the ambience of what is otherwise an attractive area. A written record should be made of the interview processes. Hot water temperatures should be checked at outlets on a regular basis. 4 5 OP29 OP38 Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Guild House DS0000016453.V314744.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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