Inspection on 09/10/07 for Guild House

This inspection was carried out on 9th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 14/11/06

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 Ms Eleanor Fox Key Unannounced Inspection 09:30 9 and 10th October 2007 th 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.V348327.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.V348327.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.V348327.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. 14th November 2006 Date of last inspection Brief Description of the Service: Guild House is an attractive property, which has been sympathetically converted and extended to provide accommodation for older people who require personal care. 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 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 £426 to £547 (a double room). Some personal items are charged extra; the individual prices are readily available in the home. Guild House DS0000016453.V348327.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 the course of two days in October 2007. The inspector checked the home’s compliance with any outstanding requirements made by the Commission for Social Care Inspection. On this occasion, she chose the care of four of the residents for particular scrutiny. The inspector spoke to each of these people, visited their bedrooms, read all their relevant care records, and, where possible, observed their participation in various activities. The inspector also looked at the medication administration processes, particularly with reference to those people who had been selected for case tracking. She observed the medication storage arrangements and the protocols in place for self-medication. She also examined the processes for recording medications, which had been administered. The inspector walked around the property, and observed the service of the mid day meal during the course of the visit. She also observed the residents’ participation in a variety of activities, meeting the activities coordinators and discussing their roles at the home. She checked that residents were able to exercise choice and to maintain social contacts. The inspector also looked at the processes in place to protect the residents from any risks. Arrangements for and records relating to the maintenance of equipment were examined. The inspector read selected personnel and recruitment records and looked at the opportunities provided for training. Finally, she spoke to the manager, and to the administrator, particularly in relation to general management issues and other responsibilities of their roles. The inspector extends her thanks to all the staff that provided assistance during the inspection processes. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 6 Prior to the inspection, CSCI surveys were distributed to residents and relatives of those living at Guild House. Fifteen were returned from residents; twelve responses were sent in from relatives and advocates and three from General Practitioners who had experience of the home. Six members of staff also returned completed questionnaires. Many of the written opinions are reflected in the content of this report. What the service does well: What has improved since the last inspection? Each resident and/or their advocate is now provided with a detailed document outlining all the terms and conditions for admission to Guild House. It was confirmed that the Abuse policy has now been reviewed and updated. However, it does not yet contain guidance for staff in the correct procedures to follow if an allegation of abuse is made. Decorative and maintenance improvements have been undertaken since the last inspection, further enhancing the environment. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 7 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 Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 8 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 9 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.V348327.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents may be assured that their needs will be met, as there is an effective assessment process in place at this home. They are also provided with detailed information about the home. EVIDENCE: It was observed that contracts outlining the terms and conditions for admission to the home had been provided to each of the residents selected for particular scrutiny. Signed copies of the completed documentation were seen in their personal files. One resident commented in their survey that, “The details were very clear and easy to understand.” Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 11 Records seen in the residents’ care files showed that careful assessments are undertaken of each person’s particular care requirements to ensure that the home is able to meet his or her needs. These processes are undertaken prior to the resident’s admission, usually in hospital but sometimes in the person’s own home. Intermediate care is not provided at this home. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People living at this home cannot yet be fully assured that all their care needs will be met appropriately. However they are treated in a manner that respects their privacy and dignity. EVIDENCE: On this occasion it was observed that all the personal care documentation is now maintained in one file for each resident, ensuring that all relevant information is readily accessible. Very thorough initial assessments are conducted; these give general details about each resident with particularly good information about the individual’s personal history. Most are signed by the resident to confirm knowledge of the content and are normally reviewed appropriately. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 13 However, guidance to staff in addressing specific care needs for each resident remain very limited. In the examples seen, there were still no instructions for one person in pressure area care although a risk of developing a sore had been identified. Another was at risk of falling. In this case there was no mention in the care records about two falls, which had occurred recently although these had been included in the home’s accident book. There were also no clear instructions to staff in the preventative measures required. The recording of personal care was very sparse. From the records it appeared that one person had only had one bath since admission, and another had had just two baths in September. Discussions with the residents themselves showed that these details were inaccurate and they appeared to be actually receiving regular and appropriate care. “Daily records”, in general, were very limited and in one case did not even give information when the person had been away from the home for a few days. Another had suffered deterioration in general health but this did not feature in the records. It was recorded for a third person that the General Practitioner had requested that arrangements be made for a nursing procedure to be undertaken on this person. It was not possible to determine from the records whether his instructions had been carried out. Members of staff on duty were also unaware about the outcome. However, there were records to indicate that care from other healthcare professionals is normally sourced when required. The continence nurse had provided advice in the care of one person; another resident had been referred for ophthalmic treatment. Psychiatric support had been provided for another person who had been displaying inappropriate behaviour. The medication administration systems relating to the four selected residents were inspected on this occasion. Storage, medication policies and the management of residents who wished to take responsibility for their own medications were also observed. In the main, medications are stored, administered and recorded correctly. However it was observed that the dedicated medication refrigerator had not been locked despite containing a number of prescribed drugs. It was also observed that care plans are not yet prepared to guide staff when medication prescribed as, ‘as required’ is to be administered. In one example, information about a resident’s possible allergies had not been recorded on the medication administration sheet, although it had been identified on the assessment documentation. Medication policies are readily available and a recent copy of a medication reference book is provided for staff information. Photographs are normally provided for each resident to assist in identification. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 14 One of the selected residents chose to take responsibility for her own medication. No recorded risk assessment had been undertaken to support her in these processes. A lockable cabinet is provided in her bedroom to use as storage and staff informally monitor the ‘as required’ medication usage. However, these are not yet documented on the home’s medication administration sheets although assurances were provided that these processes will now be introduced. Throughout the inspection, there were no occasions when members of staff were not polite or respectful to the residents. It was observed that they did not enter any bedrooms without knocking on the doors first. One person said, “I would like to compliment the staff on the happy friendly atmosphere they create.” And a relative wrote, “The majority of staff have a genuine desire to ensure residents are cared for in a dignified manner and are happy in their lives”. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are given the opportunity to take part in a good variety of social activities, if they wish, and to eat a nutritional and balanced diet. EVIDENCE: A varied and interesting plan of activities has been developed for the home. This is displayed on the notice boards for the residents’ information. One person wrote most positively about “the good social programme” and another person commented that he particularly enjoyed the trips out in the minibus. However, another person wrote, ” Very little is organised for those whose problems are physical rather than mental”. Specialist activities for those people with short-term memory loss are arranged and are being further developed with the purchase of appropriate diversional therapy equipment. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 16 The residents 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. Families and friends are welcomed into the home and it was observed that they were greeted in a most friendly fashion. In the surveys, two relatives said they would appreciate a newsletter from the home providing information about any planned events or other topical news. The manager has agreed to consider this proposal. Residents, who spoke to the inspector, confirmed that they were able to get up and retire when they wished and that they were free to eat their meals and spend their days where and how they preferred. One person particularly appreciated the opportunities given to be as independent as possible and enjoyed, “popping out to the town when I want”. The service of the main mid day meal was observed during the visit. The majority of the residents ate their meals in the large dining room; a few chose to remain in their bedrooms. A reasonable standard of food was offered and most people appeared to enjoy what they were eating although it was observed that large quantities of the desert, a fruit pie, were left uneaten and had to be discarded. A few people required some degree of assistance or gentle encouragement. Staff were observed being attentive and supportive, giving residents time to consume their meal at their own pace. One person was critical of some of the food that was provided although this person did acknowledge that efforts had been made to introduce improvements. Others were more positive with one person commenting, “You get great food here.” Another said, “They always find something I like.” A relative wrote, “The food is nutritional and her physical condition has improved since she moved into the home.” It is recommended that an easily accessible comments book should be placed in the dining room so that residents may share their appreciation or criticism of the meals provided. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home may be assured that any concerns or complaints they identify will be investigated and addressed appropriately. There are also systems in place to ensure that their rights are protected. EVIDENCE: A clearly explained Complaints Procedure has been prepared for Guild House. A copy of the document is provided to each prospective resident and/or relatives with other information about the home. The details are also displayed within the building. The inspector was given the opportunity to read information about complaints received in the home during the last year. These appear to have been addressed appropriately and, where possible arrangements made to rectify any shortfalls. During conversation, one resident said, “If anyone has a problem, we tell the manager; she will always sort it out.” Another person wrote, “I did raise concerns about the food and it has improved a bit”. And another, “I can usually find someone to put right something I am not happy with.” Abuse issues are covered in the National Vocational Qualification training, which many of the members of staff have completed. There has also been further formal training on the subject. One member of staff who was questioned displayed a reasonable understanding of the issues. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 18 Information on sourcing advocacy support is provided if the residents require this facility. Although the manager confirmed that the Abuse Policy has now been reviewed and updated the instructions do not contain clear guidance to staff in the correct processes to follow if an incidence of abuse is alleged. This additional information must now be provided. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are accommodated in a very comfortable clean property that is well maintained and furnished to suit their needs. EVIDENCE: During a walk around the building it was observed that the whole home is decorated and maintained to a very good standard. It is equipped with comfortable sturdy furniture and has many attractive features. The ground floor corridor had recently been redecorated. The whole property appeared very clean and fresh; there was only slight evidence of a mildly offensive odour in one area. Although not specifically Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 20 identified to any of the staff, a further visit to this part of the home later the same day showed that the issue had been appropriately addressed. It was observed that the home was maintained at a comfortable temperature. The laundry is well equipped; it was tidy and organised with washing segregated appropriately. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Although residents receive care from a stable group of staff, they may be at risk as members of staff are still not subject to careful recruitment processes and are not always receiving timely training. EVIDENCE: On this occasion, there were thirty-five residents living in the Home. In the morning, the Manager, one senior carer plus six care staff were on duty. In addition, the administrator, cook and three assistants, three cleaners, a laundry assistant, the handyman and the activities coordinator were also working in the home. One senior carer plus three other care staff, a cook and two kitchen assistants were due to be on duty in the evening; with two senior carers plus one more person working at Guild House overnight. All those spoken to considered that there was normally enough staff on duty to meet the residents’ needs. One person said, “If I ring the bell someone always comes right away.” And another, “They are busy but always make time to have a little chat with me.” The home has made very good progress in ensuring that the care staff are trained towards the National Vocational Qualification (NVQ), Level 2 or Level 3 in care; 69 have already achieved the qualification. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 22 Five randomly selected personnel files relating to staff employed since the last inspection were read in detail. Each person had completed an application form providing a full employment history. Records had also been maintained of the interview processes. However, correct POVA (Protection of Vulnerable Adults) and CRB (Criminal Record Bureau) screening had not been completed in four instances. Two written references had also not been provided for each person. All these employees had to be suspended until the correct recruitment processes had been completed. Discussions with members of staff showed that correct induction processes had also not been completed for staff employed in the last year. These shortfalls are being addressed and assurances have been given that they will be fully addressed by the end of the year. Observation of other training records provided evidence that mandatory training, particularly in fire prevention and manual handling, although continuing to be well overdue in some cases, is now gradually being addressed. Staff have also attended training in ‘Dying with Dignity’, ‘Care of Hearing Aids’, and ‘Protection of Vulnerable Adults’ in recent months. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents cannot be fully assured that the management systems in place at this home will ensure that they are fully protected. EVIDENCE: The registered manager has extensive experience in the care of elderly people but has met some management challenges in recent months following staffing changes at the home. Reorganisation of the responsibilities of senior staff is underway to address some of the issues. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 24 There continues to be only limited quality assurance processes in place at the home. Three relatives commented that they had little opportunity to express their views about Guild House, either positive or critical. Residents’ meetings continue to be arranged at the home and there was some evidence that residents’ comments and concerns are addressed and if possible, rectified. However, a variety of areas were identified for improvement at the last inspection and some of these have still not been addressed. The home takes responsibility for the personal monies for the many of the residents; the records relating to the four residents selected for case tracking were checked on this occasion. It was observed that individual secure storage is provided and that records are maintained accurately. Residents’ status in relation to ‘Power of Attorney’ is ascertained on admission. Records were provided to show that maintenance and inspection of equipment is undertaken, as directed by the manufacturer. Water temperatures are now checked at outlets on a monthly basis. However, there were no records to show what action is taken when they are identified as exceeding safe levels. The home has been asked to provide these. Certification has still not been provided to show that water storage areas are free of Legionella although basic bacteriology checks have been completed. An Environmental Health inspection took place in January; the issues highlighted for attention have been fully addressed. The Fire Risk Assessment was reviewed in March but the Fire Officer assessed it as inadequate in July 2007. The home is now seeking advice in reviewing the document correctly Any accidents or incidents are recorded appropriately. Security issues are generally managed well in this home although the inspector was surprised to meet a man who had entered the building unquestioned and was wandering along the corridors seeking assistance. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 25 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 3 3 x x 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 2 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 1 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 1 x 3 x x 1 Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 (1 and 2). Requirement The registered person must ensure that all care plans contain sufficient detail in the care needs of each resident. This is particularly in relation to pressure area care and reducing the risk of falls. Clear records must be maintained relating to each resident, particularly in relation to any absences from the home for over 12 hours or any other significant event. Records relating to personal care must be maintained consistently or an alternative introduced. 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 two inspections.) DS0000016453.V348327.R01.S.doc Timescale for action 31/12/07 2. OP7 Schedule 3(3) 31/12/07 3. OP9 13 (2), 15 (1 and 2). 31/10/07 Guild House Version 5.2 Page 27 4. 5. OP9 OP18 13 (2 and 4b) 13 (6) 6. OP29 Schedule 2. (1 and 3) Self-medication processes must be managed on the basis of clear risk assessment procedures. Guidance for staff in the correct procedures to follow if an allegation of abuse is made must be included in the home’s ‘Abuse Policy’. Two written references must be provided for each prospective employee. A recent photograph must be provided of the applicant. (This requirement has been repeated from the last inspection.) Each applicant for a post at the home must be subject to POVA (Protection of Vulnerable Adults) and CRB (Criminal Record Bureau) screening prior to commencing employment Each person must be fully inducted to his or her post and a record must be maintained of these processes. 31/12/07 31/01/08 31/10/07 7 OP29 8. OP29 Schedule 2 (7) And 18 (4A, 5d, 6, 8, 9, 10 and 11) Schedule 4.6g and 18(1c) 18 (1c) 13(5) 23(4d) 31/10/07 31/12/07 9 OP30 Members of staff must be receive 30/11/07 training in the work they are to perform, particularly in manual handling techniques and fire training, as specified in the home’s fire risk assessment. (The second part of this requirement has been repeated from the last inspection.) The registered persons must introduce a comprehensive quality assurance system. (This requirement has been repeated from the last two inspections.) The home must demonstrate that the hot water systems are DS0000016453.V348327.R01.S.doc 10. OP33 24 30/11/07 11. OP38 13(3 & 4) 30/11/07 Page 28 Guild House Version 5.2 free from Legionella. (This requirement has been repeated from the last inspection.) The home is also requested to demonstrate what action is taken if water temperatures at outlets exceed safe levels. 12 OP38 13(4c) Security systems must be 31/12/07 reviewed to ensure that residents are not put at risk from unwelcome intruders The Fire Risk Assessment must 31/12/07 be reviewed and updated, in line with the Fire Department’s instructions. 13 OP38 23(4) 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 OP7 OP13 OP15 Good Practice Recommendations An entry should be made in the residents’ ‘daily records’ at least once a week or more regularly if there have been any changes in condition. A newsletter should be introduced for the residents and their families. It is recommended that an easily accessible comments book should be placed in the dining room so that residents may share their appreciation or criticism of the meals provided. Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Guild House DS0000016453.V348327.R01.S.doc Version 5.2 Page 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. 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