Inspection on 22/04/05 for Heron Hill Care Home

This inspection was carried out on 22nd April 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 Hill Care Home 29/09/09

Heron Hill Care Home 23/07/09

Heron Hill Care Home 26/05/09

Heron Hill Care Home 02/06/08

Heron Hill Care Home 13/06/07

Heron Hill Care Home 07/03/07

Heron Hill Care Home 16/05/06

Heron Hill Care Home 14/11/05

Heron Hill Care Home 15/12/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Heron Hill Care Home Esthwaite Avenue Kendal Cumbria LA9 7SE Lead Inspector Marian Whittam Unannounced 22 April 2005 at 07:40 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. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Heron Hill Care Home Address Esthwaite Avenue Kendal Cumbria LA9 7SE 01539 738800 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) Abbey Healthcare Homes Limited Vacant Care Home 86 Category(ies) of Old age, not falling within any other category registration, with number (28), of places Dementia - over 65 years of age (50), Dementia (4), Physical Disability (4), Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 2) The home is registered for a maximum of 86 service users to include: - up to 28 service users in the category of OP (old age not falling within any other category) - up to 50 service users in the category of DE(E) (Dementia over 65 years of age) - up to 4 service users in the category of DE (Dementia under 65 years of age) Date of last inspection 29/12/04 Brief Description of the Service: Heron Hill is a new purpose built home caring for up to 86 residents. it opened to residents in October 2004. It is in a residential area with access to local amenities. There is access to the bus routes and train station and the town centre of Kendal is about 2 miles away. There is a car park at the front of the home. The home is on three floors and there is a passenger lift to all floors. All the bedrooms are single and have ensuite bathrooms with showers. There is a variety of adaptations and moving and handling equipment around the home to help residents move around the home. There are 2 communal bathrooms and toilets on each floor and separate communal lounges and dining rooms on each floor. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 22nd April 2005 from 07.40 to 16.15hrs. The morning and early afternoon was spent talking with residents in the lounges and in their own bedrooms, speaking to the night and day staff, cleaning staff, activities coordinator, kitchen and laundry staff and the senior nurse on duty and also looking at care plans and medicine records. Policies and procedures and records were looked at in the afternoon. Before the inspection some relatives had spoken with the inspector about their experiences. What the service does well: What has improved since the last inspection? Staffing levels have increased since earlier visits and staff said that they thought the team worked better. The home no longer used large numbers of agency staff and had a more stable staff group. Staff training has increased and is better targeted and NVQ courses are being organised for care staff. Pressure area care has greatly improved following increased training and the good standard was being kept up with regular monitoring and reporting. Care plans and assessments are better organised, more up to date overall and were clearly presented and pre admission assessments were being done in more detail. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 6 Consultation with residents over their care was better but care needed to be taken to make sure their wishes were always carried out. Regulation 26 management visits have been done regularly and the reports sent to the CSCI. After being without a manager since February a new person was due to start soon and this should provide more focus and direction for staff. 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 Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 7 contacting your local CSCI office. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 8 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 Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 9 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 and 4 The assessment process ensures that individual needs can be met when they come to live in the home. However healthcare and personal preferences had been sought but not always acted upon by staff. EVIDENCE: Individual plans of care are available and show good progress on improving the admission and assessment procedures and record keeping and making the information clearer for staff to guide them towards ensuring that residents needs are properly assessed and planned for before and at admission. Social and religious needs, hobbies and recreational needs were not always stated. Individual assessment records were done for the residents before coming in and when they were admitted. Residents and staff spoken with about the assessments and the plans developed from them showed evidence of residents being consulted about their daily life and choices. Copies of the statement of purpose and service users guide were given to residents and their families. A copy was available in the foyer. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 10 Individual assessment records, including individual choices, were done for the residents before coming in and when they were admitted. Copies of social services assessments and contracts were held on file along with the home’s own assessments. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 11 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 The healthcare needs of residents were set out so that staff had the information to meet resident’s needs but this was not always being followed so that some residents needs and choices were not being met so some residents were at risk of not having all their health care needs met. Medication administration was poor and was not in line with good practice guidelines and could place residents at risk. Personal support in the home was not being offered in such a way as to promote and respect every resident’s privacy and dignity. EVIDENCE: On examination the care plans had been improved to include more detailed and clear information with a range of appropriate risk assessments, for continence, pressure area care, falls risk assessments and nutritional assessments. Choices were recorded, for example, if they wanted a male or female carer, the times they liked to get up and if a shower or a bath were preferred. These had been reviewed and progress monitored and what needed to be written down in the plans for staff to follow. However, some things had not been recorded and some not followed up well. Actions that had been taken when conditions changed and the other agencies involved could be found written in different sections of the plan but monitoring of these was not systematic. Planned actions had not always been carried out as stated in the Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 12 care plan. Despite clear instructions staff did not seem aware of all residents needs. One resident had said they preferred a bath and records showed that they were being given mostly showers, so this choice was not being met. In some of the care plans assessment tools had not been completed correctly and no evidence to show if blood tests had been done or referrals made. There were extra assessments and advice on some needs by specialised services such as the tissue viability nurse, the community psychiatric nurse and the Macmillan nurse and reviews had been carried out by social workers. The pharmacist inspector examined medicines handling and found the administration of medicines was poor. A more detailed report of medicines administration is available in an additional visit letter from the CSCI Penrith office. There were satisfactory arrangements in place for seeing doctors and visitors in private. During the inspection the inspector saw 2 carers using a hoist to move a resident in a way that did not offer privacy or dignity. Two residents smelt of urine and despite there being sufficient staff on duty, including senior staff, residents were seen with food and drink stains on their clothing. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 13 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, 13, 14 and 15. The home provides a variety of activities but this was not adequate to meet individual social and recreational needs especially those with dementia or promote social relationships. The meals in the home offered choice and variety and catered for particular needs of residents providing a varied and nutritious diet. EVIDENCE: The home had a programme of activities and social events and had an activities coordinator. However the coordinator was leaving that day and this would again limit resident’s opportunities for social and recreational activities, especially those with dementia. The home recorded social and recreational preferences but these were often incomplete and had no evaluation and also needed to be more individualised within the planning of activities. There was little personal and social activity on a daily basis to stimulate and interest some residents especially those without regular visitors. One resident said that,” you could sit here all day long and no one would say a word”, another that “there is no one talking” and that she would like some, “friendly banter”. There was no evidence of opportunities for activities outside the home .One resident did have their own computer which he was using. A number of residents were spoken with and everyone who commented on the food said it was good and they had a choice each day. One said that “the food Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 14 was nice, I’m eating better and haven’t lost any more weight”. Breakfast and lunch times were relaxed and sociable and staff were helpful, a resident was overheard saying “thank you for a smashing breakfast” to a carer helping them with the meal. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 15 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 Complaints were not managed well. Although there were complaints policies and a procedures in place but many residents were not aware of these and some relatives were not confident that their concerns were acted upon to give residents proper protection. Adult protection arrangements were not satisfactory and staff understanding was poor placing residents at possible risk of harm and abuse. EVIDENCE: There was a complaints procedure on the notice board and in the service users guide but no log was available for tracking complaints, their investigation and the action that had been taken. Anecdotal evidence given to the inspectors, from relatives and some residents, indicated that complaints were not being properly followed up and fully dealt with. Three visits, to monitor compliance with requirements, have been made to the home by the CSCI over the last 4 months in response to concerns raised over poor care practices by relatives and other agencies so complaints monitoring and investigation was very important for the welfare of residents. The requirements made have been met and although many areas had improved initially some had now slipped back. A procedure for responding to allegations of or evidence of abuse was not available during the visit and could not be found on any of the units. Staff spoken with, including nursing staff, were not clear about what to do if they suspected abuse or who to report to. This was serious given the concerns raised at earlier visits if residents are to be protected from abuse and must be attended to. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 16 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) 19,20,21,23,24, and 26 Heron Hill is well maintained and bedrooms and social areas are decorated and furnished to a high standard to provide a comfortable, clean and homely environment for the people who live there. EVIDENCE: All furniture, fittings and décor were in very good condition and routine maintenance was being done. The home has only been open for 6 months and so wear and tear was minimal. The lounges and dining rooms were well furnished and comfortable with good lighting. All bedrooms had their own toilet, hand basin and shower and there were separate toilets close by and bathrooms. A care assistant described how staff used the hoists in the home to assist residents to have a bath, but said that, “most people had showers”. Several residents showed the inspectors their bedrooms and many had brought in their own possessions and pictures to make the rooms more personal. One resident told the inspector that the home was “nice and comfortable” and another said that they had their “own room, own shower, toilet and own Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 17 space” and one said what a “lovely view” there was from their bedroom window. However, another said that the rooms were “very nice, but all that glitters is not gold”. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 18 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) 27,28, 29, 30 Staff levels and morale has improved after a period of instability resulting in a more consistent care for residents. Recruitment procedures are not consistently robust enough to properly ensure the protection of residents. The staff training and planning has improved but supervision and support is not sufficient and must be improved to ensure staff have the skills and understanding to meet residents personal, health and social needs. EVIDENCE: There has been a high turnover of staff since the home opened with a reliance on agency staff. This has improved and staff rotas and staff levels during the visit were satisfactory with the levels of nursing and care staff on duty sufficient for the number of residents. Night staff were spoken with and confirmed that there was now always 2 registered nurses on duty at night. Day staff spoken with confirmed the rotas and said that there was usually a registered nurse and 3 health care assistants on duty on each unit, although there had been one or two occasions when a staff member had called in sick at short notice and this had caused a problem. The home is continuing to advertise for and recruit appropriately trained nurses. The recruitment practices were not consistent, and there was no evidence in the home that appropriate checks of the vulnerable adult register had been done for staff who started work before their police checks had come through. These must be attended to immediately. There was no evidence of staff having been given employment contracts, terms and conditions of employment Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 19 needed under employment law. Staff did not have current job descriptions as the home’s procedures say they should. Staff spoken with confirmed this was the case and these are important if staff are going to understand their roles and duties. Staff confirmed that they had been given training on medication, diabetes, wound and skin care and were due to get training from the Macmillan nurse on caring for people who are dying and on taking blood. Individual training files were not all up to date and some staff had not had any formal supervision. The annual staff-training programme was being developed and this was seen but was still not complete for 2005, despite this being required at earlier visits. This must be completed and the training done to make sure care and nursing staff are competent to do their jobs. The home had booked places for 6 care staff to begin their NVQ in care in September but should have a strategy on this training to make sure it was done. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 20 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) 31,32,36,37 and 38 There is poor leadership, guidance and direction to staff to ensure residents receive consistent quality care and some incidents and accidents were not being reported to the Commission. This has allowed some practices that do not promote and safeguard the welfare and safety of residents. . EVIDENCE: There was no registered manager in the home and this has been the case since the last manager resigned in February. There have been 2 acting managers in that time, both the regional managers from Abbey Healthcare Homes Ltd. One of these also resigned. A new home manager has been recruited and must apply to register with the Commission. There was only one suite manager who had been dealing with daily issues on both suites and there was a vacancy for the other suite manager. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 21 Staff spoken with said that they felt more supported now, there was a better and more flexible team now and that there was no “them and us” between the two floors as there had once been. Some staff had not had any formal supervision and the lack of both a registered manager and EMI suite manager left staff with little continuous supervision and involvement in developing practice matters on a daily basis. There was no evidence to show that staff, residents, families and other people like doctors and district nurses involved with the home, were able to have a say in the way it was run. Many of the residents spoken with made positive comments such as, “ they’re looking after me” and “they’re very nice to me”, and they helped me settle in, but some relatives had given examples of poor communication. Relatives had not always been informed about falls or changes in conditions. Accident reports had been kept but the home had not always notified the Commission about all accidents and incidents they should have as the regulations say they must. Records showed that fire training had been given but all staff needed to have their moving and handling training updated. Staff were seen by the inspector’s to be moving residents by lifting them under the arms and this is not a safe method. Chemical cleaning substances that could be harmful if taken were found in unlocked rooms and also the container for used needles. These needed to be locked away immediately. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 22 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 2 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 x 3 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 1 2 2 x x x 2 2 2 Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 23 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 OP3 Regulation 14 (1) Requirement Social interests, hobbies, religious and cultural needs must be assessed for all residents and include their individual needs. Care plans must be updated to reflect changing needs and current objectives for health and personal care and actioned. Health and personal needs and choices set out in the care plans must be carried out as detailed in the plan. Assessments must be completed correctly. Residents psychological health must be rreviewed and monitored regularly A continuous supply of medicines must be maintained at all times. A procedure for checking current medicines of service users on admission to the home must be implemented to include a record of due dates for injections. Each service user must have a complete record of all current medicines MARs must be properly maintained to include full service user name, dose administered and all signatures for Timescale for action 13.5.05 2. OP7 15 (2) 13.5.05 3. OP7 15 (1) 13.5.05 4. 5. 6. 7. OP7 OP8 OP9 OP9 15 (1) 13 (1) 13 (2) 13 (2) 13.5.05 13.5.05 1.5.05 1.5.05 8. OP9 13 (2) 1.5.05 Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 24 9. 10. 11. OP9 OP9 OP9 13 (2) 13(2) 13 (2) 12. OP9 13 (2) 13. 14. OP10 OP10 12 (4) 18 (1) 15. OP12 12 (2) and 16 (2) 16. OP16 17 (2) 17. OP18 12 (1) 18. OP18 13 (6) 19. OP29 19 administration at the time of administration. Reasons for non-administration must be recorded. Records must be complete for all received and returned medicines. Medicines that are no longer required must be returned to the pharmacy for disposal. Procedures for the handling and recording of Controlled Drugs must be reviewed to ensure that all medicines can be accounted for at all times and to ensure appropriate handling. Medicines must be administered as prescribed to include appropriate administration of bisphosphonates Residents must be cared for in a manner that respects their privacy and dignity at al times. All staff must be instructed and guidance given on how to treat esidents with respect at all times. Individalised opportunities for leisure and recreational must be made available for residents with particular consideration given to people with dementia and those with physical disabilties. A record must be kept of all complaints made and include details of the investigation and any action taken. Robust procedures for responding to suspicion or evidence of abuse or neglect must be avaiable and accessible to to all staff All staff must receive training on adult protection, abuse, physical and verbal agression by residents and the correct procedures to follow. Robust and consistent 1.5.05 31.5.05 31.5.05 1.5.05 1.5.05 1.5.05 13.5.05 13.5.05 1.5.05 1.5.05 1.5.05 Page 25 Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 20. OP29 19 21. OP30 12 (1) and 18 (1) 9 (1) (2) 21 and 24 18 (2) 37 (1) 13 (5) 13 (3) 22. 23. OP31 OP32 24. 25. 26. 27. OP36 OP37 OP38 OP38 recruitment practices including two written references must be followed for all staff before appointment. Evidence must be provided of satisfactory checks with the Protection of Vulnerable Adults register for staff commencing work whilst waiting for heir CRB The training and development programme for the home must be completed and sent to the CSCI. The new manager must apply to register with the CSCI Strategies must be in place to enable staff, residents and other stakeholders to affect the way in which the service is delivered. All staff must have regular formal supervision and supervision in the workplace. Notifications under Regulation 37 must be made to the Commission without delay. All staff must have up to date training on the safe moving and handling of residents Hazardous substances must be safely stored. 25.4.05 13.5.05 13.5.05 30.5.05 30.5.05 29.4.05 13.5.05 22.4.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP9 OP12 OP18 Good Practice Recommendations Medicines should also be kept by the home for at least 7 days following the death of service users in case they are required by the Coroner. An trained activities coordinator should be recruited quickly. Staff should have access to a copy of the Department of Health guidance No Secrets. F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 26 Heron Hill Care Home 4. 5. 6. OP27 OP28 OP29 Rotas should state the capacity a member of staff is working in. A strategy should be in place o make sure that the target for NVQ traing can be achieved quickly. Staff should have statements of terms and conditions of employment. Heron Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection Eamont House Penrith 40 Business Park, Gillan Way Penrith Cumbria, CA11 9BP 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 Hill Care Home F58 F10 s59537 Heron Hill v208789 210405 ui Stage 4.doc Version 1.30 Page 28 - 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!