Inspection on 30/08/05 for Harewood House

This inspection was carried out on 30th August 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Harewood House 13/07/07

Harewood House 10/08/06

Harewood House 14/02/06

Harewood House 17/11/04

Harewood House 26/05/04

Harewood House 02/12/03

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

CARE HOMES FOR OLDER PEOPLE Harewood House 66 Plymouth Road Tavistock Devon PL19 8BU Lead Inspector Graham Thomas Announced 30 August 2005 th 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 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. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Harewood House Address 66 Plymouth Road, Tavistock, Devon, PL19 8BU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01822 613130 01822 610379 info@devon.gov.uk Devon County Council Brian Burley Care Home 28 Category(ies) of Dementia (8), Dementia - over 65 years of age registration, with number (8), Old age, not falling within any other of places category (20), Physical disability (8), Physical disability over 65 years of age (14) Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The Home can accommodate no more than 14 people with a physical disability at any one time. Anyone with a Physical Disability must be 50 years of age or over. The Home can accommodate no more than 8 people with dementia at any one time. Any one with dementia must be 55 years or over. Date of last inspection 17th November 2004 Brief Description of the Service: Harewood House is arranged on three floors. The Ground floor comprises a day centre, offices, laundry and kitchen facilities. The Kitchen provides for the day centre and meals on wheels service as well as the care home. Food is distributed to the home in heated trolleys. The first and second floors which comprise the care home are divided into four units, each offering a service. On the first floor there are two units. Edgecombe provides long term care for 6 people whose main needs relate to frailty due to their age. There are 6 large bedrooms, a lounge and a kitchen/diner. In addition there are 2 toilets (one with disabled access), a bathroom with a floor based hoist, and a sluice room. Reablement provides for 6 people who need to restore their skills and confidence following an operation, accident or period of ill health. This service is run in conjunction with the Health Service. Intensive support from Occupational Therapists and Physiotherapists is available. On the second floor Drake is a service for 8 people who have a diagnosis of dementia. There are 8 large bedrooms, a lounge and a kitchen/diner. In addition there are 2 toilets (one disabled access), a bathroom with a high/low bath, a small laundry and a sluice room. Treetops is a service for 8 people and whose main needs relate to frailty due to their age and who are staying at the home for a period of respite care. There are 8 bedrooms, 2 of which are suitable for the use of people with a physical disability and are situated on the first floor; 2 toilets (one with disabled access); a walk in shower; a kitchen diner and a lounge. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included a review of pre-inspection information provided by the Registered Manager. A tour of the building was conducted. The inspector spent time with 15 service users in groups and individually. Two visitors were spoken with as well as five staff and the Registered Manager. A total of 17 care plans were inspected as well as various other documents including staff files and health and safety records. What the service does well: What has improved since the last inspection? What they could do better: Service users do not receive confirmation that the home can meet their needs. Care plans do not contain information that is adequately detailed. The plans do not show clearly how they have been progressed or whether service users have been involved in reviewing them. Treatment regimes are not adhered to consistently. The home has yet to be assessed by a relevant professional for any necessary adaptations. Staff induction training requires improvement. Service users views do not underpin the development of the home. Confidential records are not always securely stored. Some health and safety checks need to be completed or properly recorded. Please contact the provider for advice of actions taken in response to this Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 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 standard(s) 1, 3, 4 and 6 Information provided to service users has improved. However, they are not provided with complete information to make an informed choice about living at the home. EVIDENCE: The home has produced a Statement of Purpose and Service Users Guide to provide information for service users and other interested parties. All the information required by the National Minimum Standards and Care Homes Regulations is included in these documents. This includes the contact details of support agencies as well as details of how to contact the Commission directly. The Service Users Guide has been modified to include information required at the last inspection such as details of pre-admission visits to the home. Copies were provided to the Inspector. Care plans included pre-admission assessments including the assessments of referring agencies. The assessments varied according to the unit to which service users were admitted and the referring agency. For instance, files seen for those admitted from hospital contained detailed occupational therapy, Physiotherapy and Nursing assessments. Those admitted at short notice (e.g. for respite) contained less detailed assessments but files showed that further Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 9 details had been acquired after admission. A strategy is in place for obtaining as much pre-admission information as possible where service users are discharged from hospital to the home at short notice. Individual service users with whom the Inspector spoke felt that their needs were adequately met. Discussion with staff, service users and the Community Physiotherapist, (based part-time in the home), indicated that there is good liaison with health and other services to meet individual need. This was confirmed in individual records. Staff recruitment difficulties have resulted in an over-reliance on agency staff. There was some evidence that compliance with physical treatment regimes prescribed for individuals had suffered as a result. However, at the time of inspection the Registered Manager was in the process of recruiting new staff and rearranging staff roles and hours to improve this situation. Individual staff had attended various courses in subjects relevant to the needs of service users such as dementia and mental health. Prospective service users do not yet receive confirmation prior to admission that their needs can be met by the home. This was a requirement at the last inspection. The “Reablement” unit offers intermediate care to a maximum of 6 Service Users at any one time. The Unit has it’s own facilities, staffing and equipment. Occupational therapists and Physiotherapists working within the NHS provide additional support. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 and 10 Service users’ individual needs and plans for meeting them are not adequately set out. Personal and healthcare needs are generally well met and individual privacy and dignity is respected. EVIDENCE: Each service user has a plan of care. The information contained in the plans seen covered areas of personal, health, psychological and social needs. However, the quality and quantity of information contained in the files varied considerably. A form is included to provide a pen picture of an individual service user and their needs. In some files this contained detailed and useful information which conveyed a clear picture of service users whose past occupation, interests, likes, dislikes and personality might not otherwise be evident. In other files this was limited to one or two sentences. Not all files contained a photograph of the service user. Plans did not show a clear cycle of assessment, planning, action and review. Assessment and care planning were not clearly separated. Many of the documents in the plans seen had not been signed and dated. Service users’ involvement in the review process was not always clearly evidence in the files. Discussion with staff and service users indicated that individual healthcare needs are generally well met. Links with local health services are good and Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 11 service users’ files contained evidence of both specialist and routine medical treatments. There was some evidence that a present over-reliance on agency staff has reduced compliance with prescribed physical treatment regimes (See “Choice of Home” above) though steps are being taken to reduce this risk. Service users who manage their own medication are provided with lockable storage and risk assessments are completed. Other medication in the home is securely stored in locked cabinet in a lockable room. There were no controlled drugs in use at the time of inspection. Since the last inspection, a new record book for controlled drugs has been obtained in accordance with a requirement made at that inspection. A monitored dosage system is used in the home. Records for the administration of medicines were sampled and found to be in order. General reference information for staff concerning medications is available. It is recommended, however that a file should be kept of current Patient Information Leaflets for all medications in use. The Registered Manager stated that only he and the duty managers administered medicines. Those administering medication have received training as well as some other staff. Evidence was seen of regular visits by the Pharmacist. Service users and relatives stated that they felt they were treated with respect and that their dignity was preserved. Interactions between staff and service users were observed which were supportive and respectful. Service users confirmed that medical consultations and personal care take place in private. Toilets and bathrooms are fitted with suitable locks and service users who are able have their own room key. Care plans identify where this facility is unwanted or not possible. Access to the telephone is provided from a phone booth and cordless phone facilities for incoming calls. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 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 standard(s) 12-15 Service users are adequately supported to maintain and pursue the lifestyle and social activities of their choice EVIDENCE: The care plans sampled contained details of service users interests though the recording was erratic. Service users and staff confirmed that table top games and activities take place daily. Twice weekly bingo games are held and visiting musicians entertain service users monthly. During the inspection, some service users were being supported to use facilities in the local community. Activities are posted on the home’s notice board and further information is provided in a newsletter. At the time of inspection, the Registered Manager was in the process of reorganising staffing. This reorganisation will free care staff time through the employment of a laundress and a part-time community support worker specifically to enable community based activities. Two visitors confirmed that they were made welcome and were content with the home’s visiting arrangements which are set out in detail in the Service Users Guide. Service users confirmed that they were able to receive visitors in private and decline to see a visitor if they wished. Attendance at local social events is supported by the home. Service Users are encouraged to handle their own finances, although some are supported by relatives. Banking services are available to service users who are unable to manage their own finances. Service Users rooms contained various Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 13 personal possessions which they had brought with them. Documentation is available in the ground floor lobby relating to advice and support services through Social Service and Age Concern. Service Users can access their personal files if they wished to. Meals are prepared in the ground floor kitchens and conveyed to the home in heated trolleys. Service users stated that they enjoyed the meals provided and confirmed that daily choices were available. Fresh fruit was seen around the home and inspection of the kitchens showed that other fresh ingredients are used. Discussion with the chef confirmed that specialist diets are catered for and that liquidised meals are presented as separately identifiable items. The current menu is based on a 13 week cycle which is seasonally adjusted. This appeared to offer a balanced and wholesome diet. Meals actually taken by service users are recorded. The Inspector joined a group of service users for a meal which was taken in a congenial atmosphere. Staff offered individual assistance where required. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 Service users can be confident that they can air their concerns and that these will be acted upon. Adequate systems are in place to protect service users from abuse. EVIDENCE: The home has a complaints procedure which is made available in the Service Users Guide. This contains details of how to contact the Commission directly. Details of complaints and compliments are held on file. These details included responses to complainants. Service users stated that they felt staff listened to any concerns they might air. Policies and procedures concerning the protection of vulnerable adults from abuse are in place. Staff files examined provided evidence that checks are made on prospective staff including references, criminal records checks and checks against the national list for the Protection of Vulnerable Adults. Upon recruitment, staff sign an agreement that they may not benefit from gifts or legacies. Records are maintained of any valuables brought to the home by a service user. Most staff have received training in the protection of vulnerable adults from abuse. The registered Manager is advised to update this training to take account of national developments in best practice set out in the Department of Health’s “No Secrets” guidance. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 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 standard(s) 19, 22 and 26 Service users are provided with a generally clean, comfortable, safe and wellmaintained environment. EVIDENCE: A tour of the home provided evidence of ongoing maintenance, redecoration and refurbishment. Some areas and individual rooms had been recently redecorated and re-furnished to provide greater comfort and convenience for service users. Records of routine maintenance were available for inspection. One bath was identified which is worn and due for replacement. The home’s grounds were seen to be attractively maintained, safe and accessible. Discussion with the Registered Manager confirmed that décor unsuitable for the needs of service users with dementia (e.g. strongly patterned walls and carpets) is being changed. A fire risk assessment has been conducted and a fire plan was seen. Staff files and discussion with staff confirmed that they receive training in fire safety. The main entrance to the premises is covered by a CCTV camera for security purposes. Many aids and adaptations were seen around the home including electronically adjustable beds, grab rails toilet seat frames and bath hoists were seen. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 16 Individual assessments for aids/adaptations were seen in care plans. An assessment of the premises by a suitably qualified person has yet to be conducted. On inspection the home was clean and free from offensive odours. Staff were observed practising hygiene and infection control measures such as the use of rubber gloves and aprons for cleaning. Sluicing facilities have gloves and aprons available for staff use. The laundering of bedding and clothing is separated from that of table linen by the use of two separate laundry facilities. Each of these has cleanable walls and impermeable flooring. The Registered Manager stated that the washing machines were able to operate the required cycles for foul laundry. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Service users needs are met by an adequate number of staff. New staff are do not receive adequate induction and foundation training. EVIDENCE: Staffing rotas are maintained which were available for inspection. Generally, there are six staff on duty in the morning and five in the afternoon / evening. This is in addition to the Registered Manager and an Assistant Manager. Two staff provide waking night cover and an Assistant Manager sleeps in. There is additional staffing for maintenance and domestic duties. The Registered Manager referred to difficulties in local recruitment which had resulted in the use of agency staff. Where possible, continuity of the staff used had been maintained. Some revision in the use of staffing resources was taking place at the time of inspection. This included the recruitment of a laundress and community resource worker. These changes are being undertaken to free more care staff time for direct support and enable more community activity. Recruitment practice was examined through staff files and discussion with staff. Two pre-employment references are obtained as well as checks against criminal records and the national Protection of Vulnerable Adults register. Statements of terms and conditions are received by staff as well as copies of the General Social Care Council’s codes of practice. A previous requirement concerning documents to be held no longer applies due to a change in the Care Homes Regulations 2001. Staff receive an in-house induction. However induction and foundation training to national standards is not presently provided. Inspection of staff files Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 18 revealed a variety of training including health and safety topics as well as subjects relevant to service user need such as dementia and mental health. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35, 37 and 38 The development of the home is inadequately linked to service users’ and other stakeholders’ views. Measures to safeguard service users’ health safety and welfare and confidentiality require improvement. EVIDENCE: Findings in respect of the home’s quality assurance system remain substantially unchanged since the last inspection. The “Reablement” Unit has been accredited to ISO 9001:2000. This is an independently recognised quality assurance system that is externally audited. The Service Users of this unit are surveyed after each visit to ascertain their views on the services provided: Social Services and the Primary Care Trust monitor the results of these surveys. The Registered Manager has ensured that the policies and procedures and best practice from this unit that relate to the other 3 units have been shared. The Service User Guide contains a questionnaire that enables Service Users and their families to give their views of the home. However, there is no Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 20 formal system to ascertain the views of other stakeholders such as Care Managers, Chiropodists, GPs or District Nurses. No annual development plan, informed by the views of service users, has yet been formulated. Service users are encouraged to manage their own finances where possible. Amounts of up to £50 are held in the home for individual service users for which there are records of transactions. Since the last inspection the banking arrangements for individual service users have changed. Written confirmation has been received from the Local Authority that banking and financial arrangements for service users unable to manage their own affairs protects their individual interests. The records inspected were well organised and, with the exception of those specifically identified elsewhere in this report, in good order. However, records concerning medication were found to be left in an open office. Similarly the care plans in one unit were stored in a lockable cabinet within a lockable office. This was left unattended with keys left in both the cabinet and office door. Health and safety issues were examined. Staff files showed that they had received training in moving and handling and manual handling assessments had been completed. Fire safety procedures were posted in the home and a fire risk assessment had been conducted. Staff had received fire training and records showed regular testing of fire equipment. The Registered Manager stated that there was a qualified first-aider on duty at all times and staff files provided evidence of first aid training. A recent environmental health inspection report was seen and evidence provided that its recommendations are being followed. Food was found to be correctly stored . Records are maintained of fridge and freezer temperatures. Staff were observed using infection control methods (using aprons, rubber gloves). Hand washing facilities are available in critical areas as well as antibacterial hand wash. Laundry is separated so that foul laundry is not washed with table linen. Hazardous substances were found to be securely stored and reference information was available for staff. Satisfactory records concerning boiler maintenance were seen. Electrical wiring systems had been checked. The Registered Manager stated that portable electrical appliances had been tested but this was not effectively recorded. A legionella risk assessment required at the last inspection remains outstanding. Accident records were available for inspection. Staff files contained evidence of health and safety training. Events affecting the health and welfare of service users are not all reported to the Commission as required by regulation Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 2 x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x 2 x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x 2 2 Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 22 Yes Are there any outstanding requirements from the last inspection? 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 4 Regulation 14 Requirement Timescale for action 30.9.05 2. 7 15 3. 37 17 The home must confirm in writing to prospective service users, and those admitted as an emergency, confirming whether or not the home is suitable for the purpose of meeting their needs in respect of their health and welfare. (Previous timescale of 31.12.04 not met) 30.11.05 The home must ensure that the service users’ care plans reflect and describe in full the service users’ current care needs, including personal, health, social, nutritional and diet and spiritual care needs, as well as the action required by staff to meet those needs. The home must distinguish between the preadmission assessment and the current care plan. The plans must show a clear cycle of assessment, action planning and review. The home must review the care plans monthly and record the service user and/or relative’s involvement. (Requirement modified. Previous timescale of 31.1.05 not met) Service users records must be Immediate D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 23 Harewood House securely stored 4. 5. 38 38 13 13 Up to date records must be maintained of all electrical portable appliance testing. The must have a current risk assessment for the control of Legionnaires Disease. (Previous timescale of 31.3.05 not met) The home must notify the Commission for Social Care Inspection of all incidents that affect the health and well being of the Service Users. (Previous timescale of 30.11.04 not met) and ongoing 31.10.05 31.10.05 6. 38 37 Immediate and ongoing RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. 8. Refer to Standard 8 9 18 19 11 22 30 33 Good Practice Recommendations The Registered Manager should ensure that agency staff are aware of and act upon all plans for physical treatments Current Patient Information Leaflets should be held for all medications in use in the home Staff training in the Protection of Vulnerable Adults should be updated to include current best practice and procedures. The worn bath identified at this inspection should be replaced The home should record the Service User’s wishes concerning terminal care and funeral arrangements in their care plan. A suitably qualified person with specialist knowledge of the client group should undertake an assessment of the premises and facilities. The home should provide induction and foundation training that meets the National Training Organisation’s specifications. The home should expand its quality assurance monitoring to all of the service users, their families and friends and stakeholders in the community. The home should provide an Annual Development Plan based on a systematic cycle of planning – action – review, reflecting aims and D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 24 Harewood House outcomes for service users. Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Harewood House D54-D07 S32457 Harewood House V214518 300805 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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