Inspection on 22/11/05 for Heron Court

This inspection was carried out on 22nd November 2005.

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

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

Other inspections for this house

Heron Court 10/11/06

Heron Court 05/07/05

Heron Court 15/02/05

Heron Court 18/10/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Heron Court 198 Brentwood Road Herongate Brentwood Essex CM13 2PN Lead Inspector Ms Vicky Dutton, Ann Davey Unannounced Inspection 22nd November 2005 09:00 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 Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Heron Court Address 198 Brentwood Road Herongate Brentwood Essex CM13 2PN 01277 810236 01277 812560 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) Runwood Homes Plc Ms Deborah Doyle Care Home 35 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (35) of places Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th July 2005 Brief Description of the Service: Heron Court provides care and accommodation for thirty-five older people. Seventeen of these beds are registered for service users who have dementia. The home consists of an original three storey old house, which is a listed building, and two single storey units which are a later addition. The main house accommodates service users on two floors and access to all areas is maintained by way of a passenger lift. The second floor is for the use of the staff only. There are a variety of communal spaces, in addition to a dining room. The premises are set back from the road and are contained within an ornamental garden, which has a pond, greenhouse and gazebo. There are pubs and a village store close by. The nearest shopping centre is Brentwood where there is also a train station. The home is served by a bus service. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of seven and a half hours. As there were two inspectors, this equated to fifteen hours of input. The inspection focused mainly on the progress the home had made since the last inspection, although a number of other standards were also considered. The registered manager of Heron Court was available and assisted throughout the day. The inspectors were also assisted by care team managers (CTM’s) and other staff at the home. A partial tour of the home took place. Staff, residents and visitors were spoken with. Records were selected at random and inspected. A notice was displayed in the main entrance area advising all visitors to the home that an inspection was taking place with an open invitation to speak with an inspector. The inspectors gave a full and detailed ‘feedback’ to the manager with opportunity for clarification and/or further discussion. A photocopy of the inspectors ‘premises audit’ was also given to the manager. What the service does well: What has improved since the last inspection? For the benefit of residents a hairdressing room has been developed. The registered manager has returned to the home after a period of working at another home operated by the registered provider. Visitors spoken with were positive about this. An activities co-ordinator has recently been appointed. It is hoped that this will lead to improvements for residents and that they will experience a greater level of activity in their daily lives. Some refurbishment and decoration has taken place in the building to improve the environment for residents. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 6. Information is available to tell prospective residents and other people about the services offered at Heron Court. Resident’s needs are generally assessed before they move into the home. Development is needed to ensure that staff understand new residents needs and have the skills to meet them. EVIDENCE: Although not specifically assessed at this inspection the inspector was given a copy of the recently revised Service Users Guide for Heron Court. This gives residents information about the services provided at Heron Court. It was planned that copies of this document would be placed in all bedrooms. Some bedrooms viewed at this inspection contained copies of the homes Statement of Purpose. Apart from a resident admitted as an emergency, it was seen that the home had carried out an assessment of residents needs before they moved into the home. Social work and other information was also available. The home need to ensure that information gathered and admission plans made are clear to staff so that the admission process is as smooth as possible for residents. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 9 Staff have received relevant training in areas such as dementia care to assist them in meeting residents needs. However findings at this inspection showed that the home are not always successful in meeting residents identified needs. In particular concerns were raised with the manager regarding the care of one recently admitted resident. Although accommodating a resident with a significant visual impairment, staff have not received training in this area. The home is registered to provide care for residents who have dementia. On the day of inspection a number of hazards were identified that could compromise their safe care. Intermediate care is not provided at Heron Court. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 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, 10, 11. In general residents health and care needs are well identified and planed for. However development work is needed to ensure all staff are involved in this process, and that care staff deliver care based on a detailed knowledge of individual residents needs. Medication practices at the home are well managed and ensure that residents are kept safe. However, attention to detail is needed in respect of managing creams and other items. EVIDENCE: As part of this inspection several care plans were viewed. In general they were detailed and addressed all aspects of assessed needs. However some shortfalls still remain. This relates mainly to the fact that care plans do not demonstrate a holistic approach to care. Residents may have a care need that relates to many different aspects of care, but it is only identified as an isolated need. Examples of this were given to the manager. Another issue is that although care plans are comprehensive, in general they are prepared and managed by senior staff. This means that care staff working with residents may have a limited awareness of residents care needs. This will hamper their ability to adequately meet resident’s needs or work with them in an effective and consistent manner. The manager said that training is planned to try and address this. Although risk assessments and care plans were in place for Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 11 residents who use bed rails, there was no evidence to show that the use of these had been established through a multidisciplinary assessment. Records showed that resident’s health care needs are catered for and that they can access professional services such as chiropody, optician and local and hospital based health services. Development is needed to ensure that a full and accurate record is kept of what residents have eaten. Resident’s spoken with were generally satisfied by the level of care offered by the home. Medication at the home is generally managed well. The system was well organised and staff were able to identify that they had undertaken appropriate training. Development is needed to ensure that residents are kept safe by the effective management and use of creams, homely remedies and other medical supplies. These were found in some bedrooms and were often unlabeled or labelled incorrectly. In one case an ear preparation dispensed in July, and with advice to use within 28 days, was still in place on a residents bedside table. In general residents privacy was respected by the shutting of doors and other actions. The homes pay phone is not situated in an ideal place to promote residents privacy, being in an open corridor close to the office. The manager said that residents often took calls in their rooms on the homes ‘hands free’ telephone. This was observed during the inspection. One bedroom at the front of the house was fully exposed to the entrance and car park area of the home. The manager undertook to see if the resident wished for net curtaining or other remedial actions to safeguard their privacy. Resident’s wishes in respect of their funeral arrangements were seen to be recorded. Other aspects of this standard were not assessed. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Some activities are provided at the home, but these do not provide sufficient stimulation and occupation for all residents. Visiting at the home is open. Food at the home is generally good but menus should be clear so that residents know what choices are available to them. Mealtimes should reflect resident’s needs and expectations. EVIDENCE: An activities co-ordinator who works 25 hours per week (during Monday to Friday) has recently been appointed at Heron Court. The registered provider employs a dementia specialist who has been working with the co-ordinator on one day each week to provide training. An activities timetable was in place but this was limited in scope and provided opportunities for a limited number of residents. During the inspection residents, although generally supervised by staff, were offered little opportunity for activity and occupation. Resident’s freedom of choice is sometimes restricted by staff as they are encouraged to remain in the lounge/dining areas and stay sitting down. At lunchtime residents who require the use of a hoist were left in armchairs to have their meal from an over bed style tables. Records viewed and resident’s spoken with identified that their spiritual needs are identified and opportunities given for these to be met. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 13 Visitors came and went freely during the inspection and were clearly made welcome. Information on advocacy services was available to residents and families. Some resident’s bedrooms showed that they were able to bring in personal possessions. Residents spoke well of the food provided by the home. The manager felt that a catering survey had been recently been undertaken but this could not be found. Similarly no current menus could be found. It appears that currently menus are planned on a day to day basis. Although a choice is offered at each meal, residents are not always given a clear indication of what will be on the menu. This is particularly true of the teatime menu when TBA (to be arranged) was sometimes recorded on the meal selection sheet used for residents. The manger said that breakfast at the home is served from 09.00, lunch at 12.30 and ‘tea’ at 16.45. Although a suppertime milky drink and snack is offered, the spacing of meals should be reviewed. If residents choose to go to bed early, as one resident confirmed that they did, there is a potential gap of 16 hours between meals. Lunch on the day of inspection looked appetising and was well presented. To ensure that residents eat in pleasant surroundings attention to detail is needed. As stated above some residents were not offered the choice of sitting at a proper dining table. On the day of inspection it was noted that no cloths were used on the dining tables, place mats were in a poor condition, and cutlery was mismatched. All residents, including those more able, had plastic beakers to drink from. Residents were not offered napkins but given paper towels. Some resident’s were given blue plastic aprons to wear. Most of these issues had been raised at the previous inspection, but not yet been addressed. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. The home has an established complaints procedure in place, but complaints need to be properly recorded and followed through to their conclusion. Residents are protected by staff having a good understanding of adult protection procedures. EVIDENCE: The home has a clear complaints process in place, and issues are recorded. However the process followed to resolve these complaints, or if they had been properly investigated or resolved was unclear due to poor recording processes. Specific examples of this were pointed out to the manager. In general both care and senior staff spoken with had a good understanding of adult protection issues. Records showed that training had been undertaken in this area. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25, 26. Many aspects of the premises are unsatisfactory and need addressing so that residents have a safe and homely place to live. EVIDENCE: Heron Court was noted to be generally clean, tidy and odour free. Where pockets of odour were identified the manager was addressing this. The home is situated in a rural area and is set back from the road. As part of this inspection a tour of the premises was undertaken and full feedback given to the manager. A photocopy of the notes taken during the ‘premises audit’ were also given to the manager. Previous inspection reports have raised concerns about the condition and maintenance of the building. Some refurbishment of the premises has taken place, but many areas are left to address. It is understood from the registered provider that plans are now in hand for a major refurbishment of the home to take place. The home has extensive grounds, which includes some outbuildings such as greenhouses and a summerhouse. These were in a run down state. There is a small pond in the grounds. There is also a fenced garden with gazebo suited to service users with dementia. Some of the fencing in place to make this area safe was broken. All external Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 16 areas were somewhat overgrown and would benefit residents more if they were well maintained. Residents at the home are benefiting from a newly developed hairdressing room. This needs some finishing touches such as mirrors to enhance resident’s experience. As at previous inspections communal space in the two ‘links’ was tight and would not provide sufficient communal space should all nine residents that might live in each ‘link’ choose to use these areas. The main lounge area in the home did not provide sufficient coffee tables. This left residents at risk as they were left holding hot drinks. Since the previous inspection two of the homes bathrooms (non assisted) have been decommissioned, one to provide a hairdressing room and one to provide a visitors room. Neither of theses areas have been completed. CSCI had not been notified of these changes to the registered provision. This leaves the home with three assisted baths, and two shower rooms. Many bathrooms and toilet areas at the home are in need of refurbishment. Some bathrooms contained items such as disposable gloves and pad bags. As the home is registered to provide a service to residents with dementia this could pose a hazard. To assist residents it should be possible for them to identify hot from cold taps. In many areas this was not possible. Hoists and moving and handling equipment was available to assist residents. The home is registered to provide dementia care. Although efforts to improve signage had been made, some areas were still lacking. Signage and orientation devices must be improved to assist residents with orientation. As identified at previous inspections, furnishings and fitments in resident’s private accommodation were, in most instances, quite shabby and worn. In many rooms the furnishings do not match. Some rooms have no lockable storage. Some bedding was in poor condition and pillows stained. Beds were not equipped with mattress covers to ensure residents comfort. Many bedrooms were not homely. On the day of inspection the home was warm and well ventilated. Water temperatures tested at random were satisfactory, though some initially ran hot. This needs to be managed so that residents are kept safe. The laundry was inspected and found to be clean, tidy and well organised. However the laundry had been left with the door open and no staff in attendance, this could place residents at risk should they enter this area. During a tour of the building, and later observations some health and safety/Infection control issues were identified. Clinical waste bins needed to be hand operated, staff did not always demonstrate good infection control practices, and towels were not in place in en suite areas. Bin lids were missing in the kitchen and no paper towels were available in this area. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Established staffing levels are maintained, but these need to be monitored to ensure that residents are kept safe and have their needs met. Staff are recruited safely and receive training to carry out their roles. Development is needed to ensure that staff put training into practice when working with residents. EVIDENCE: The minimum staffing levels at Heron Court are: • Five care staff and one senior care during the morning. • Four care staff and one senior care during the afternoon and evening. • Two care staff and one senior care at night. On the inspectors arrival the home was operating at one member of staff below these minimum levels due to a member of staff being late in. Assurances were given that this was a one off event. The homes rotas were inaccurate in that they did not include all staff working at the home. This was addressed during the inspection. The manager felt that staffing levels were sufficient to meet the dependency needs of current residents, but this was not fully demonstrated during the inspection. Staffing levels must be kept under review to make sure that resident’s needs are fully met. Ancillary staff are employed at the home. The home has lost some staff recently and currently have 104 vacant care staff hours per week. Rotas show that there are also shortfalls in domestic and kitchen cover, particularly at weekends. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 18 The manager reported that two staff currently hold NVQ level two and that a further four staff are undertaking this. One member of staff has commenced NVQ training at level three. The manager said that no new care staff had been recruited since the previous inspection. However the activity co-ordinator was recently appointed. Records showed that appropriate recruitment checks had been carried out. Existing staff files and training records showed that staff are provided with appropriate training opportunities. Observations during this inspection showed that training given, such as dementia care and infection control training is not always put into practice. The records of recently appointed member of staff showed no evidence of appropriate induction or training having been given. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38. Many issues raised in this report, particularly in relation to the premises have been outstanding for some time. The registered person has a responsibility to manage the home effectively by identifying and addressing these issues. Resident’s finances at the home are well managed. Staff at the home are appropriately supervised. Some health and safety issues have been raised through the report. EVIDENCE: A visitor spoken with praised the manager at the home, and was pleased that she had returned to Heron Court. The registered manager is experienced and holds appropriate qualifications. The registered manager tries to encourage an open atmosphere. Although only recently returned to the home, staff and resident meetings have been held with further meetings planned. It was advised that residents meetings Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 20 and other activities are advertised in a location more likely to attract their attention, than where currently sited outside the office. The registered provider has strategies in place to monitor the quality of the service provided. An annual audit of the service has been conducted. The registered provider also nominates an operations manager to conduct a monthly visit to the home to seek the views of people using the service, and make sure that the home is being managed correctly. The manager said that quality questionnaires had been conducted with residents, but no recent ones could be found. Copies of any review reports compiled by the registered provider should be made available to residents and other interested parties. Resident’s finance records were sampled. These were satisfactory. Staff records showed that, apart from a recently appointed member of staff, regular supervision and staff appraisals take place. This ensures that staff are supported in their roles. Records showed that staff are trained in moving and handling and other core areas. On the day of inspection some poor moving and handling practice was noticed to be carried out by agency staff. Details of this were given to the manager. Other health and safety issues have been identified in this report. In particular it was concerning that hazardous materials such as COSHH products, and scissors had been left accessible to residents. A boiler room had been left unlocked creating a potential hazard to residents. This was rectified during the inspection. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 2 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 1 2 2 2 X 2 2 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X 2 Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP4 Regulation 18 Requirement Timescale for action 01/01/06 2. OP7 15 3. OP7 15, 18 Staff must receive training appropriate to the work they are to perform. This refers to the need for staff to have an awareness of the specific conditions and assessed needs of residents. This includes visual impairments. Care plans need review to 14/01/06 ensure that the information they contain is comprehensive and provides a holistic approach to care. Staff should receive appropriate 01/02/06 training so that they can be involved in the care planning process and have a greater understanding of residents care needs. Previous requirement date of 01/10/05 not met. 4. OP8 12 Resident’s health and welfare needs must be properly promoted. This refers to the need for nutrition records to be maintained fully and accurately. 14/12/05 Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 23 5. OP9 13 6. OP12 16 The registered person must 14/12/05 make arrangements for the safe management of medicines at the home. This refers to the to the shortfalls noted concerning topical (creams & lotions) applications. The Registered Person must 01/02/06 consult with service users about their interests and provide a programme of activities and provide facilities for recreation. The routines of daily living and activities made available must be flexible and varied to suit all service users expectations, preferences and capacities. Previous requirement date of 01/09/05 not met. The registered person must conduct the home in a way that takes account of their wishes and feelings and promote their health and welfare. This refers to the need for mealtime routines and the provision of food to be reviewed in accordance with the findings in this report. Complaints should be fully investigated and a record kept of this process and any outcomes. Previous requirement of 01/09/05 not met. The Registered Person must ensure that the premises and grounds are kept in a good state of order/repair. This refers to the issues raised in the body of the report. Previous requirements of 22/03/05 and o110/05 not met. A programme and timescale of repair, replacement, 14/01/06 7. OP15 12 14/12/05 8. OP16 22 14/12/05 9. OP19OP21 OP24 23 Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 24 10. OP20 23 redecoration and maintenance must be sent to the Commission. The Registered Person must ensure that there is adequate sitting, recreational and dining space separately from the service users bedrooms. This refers to the limited communal space in the link areas of the home. Previous requirement of 22/03/05 and 01/10/05 not met. 01/04/06 11. OP20 23 12. OP26 12 The Registered Person must provide premises suitable to meet the aims and objectives set out in the Statement of Purpose. This refers to the need to providing an appropriate layout of rooms with occasional tables etc. to ensure the safety and comfort of residents. The registered provider must assess the risk to residents posed by the open laundry area and take appropriate remedial actions. Previous requirement of 01/09/05 not met. 01/01/06 14/12/05 13. OP26 13 14. OP27 18 The registered person must make suitable arrangements to prevent the spread of infection at the home and maintain the home in a clean and hygienic condition. This refers to the infection control and hygiene issues raised in the body of the report The registered person must review and be able to demonstrate that sufficient staff are on duty at all times to fully meet residents assessed needs. This refers to the issues raised in the body of the report. DS0000018041.V267620.R01.S.doc 01/01/06 14/12/05 Heron Court Version 5.0 Page 25 15. OP30 18 16. 17. OP33 OP38OP26 OP25OP21 OP20OP19 24 13 The registered person must ensure that robust induction process is in place for all newly recruited staff. The registered person should make copies of any review reports available to residents. The registered person must ensure the care home is conducted to promote the health and welfare of resident’s. This refers to the need for the many health and safety issues identified in this report to be addressed. 01/02/06 01/04/06 01/01/06 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. 4. 5. 6. Refer to Standard OP7 OP10 OP15 OP19 OP22 OP28 Good Practice Recommendations The use of bed rails should be established through a multidisciplinary process. The positioning of the homes pay phone should be considered. The quality of dining equipment such as cutlery and mats should be reviewed. The hairdresser’s rooms should be finished off and provide mirrors and other homely touches for residents. Signage should continue to be improved at the home to assist residents who may be confused or have dementia. 50 of care staff should be trained to NVQ level two or above by 2005. Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Heron Court DS0000018041.V267620.R01.S.doc Version 5.0 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!