CARE HOMES FOR OLDER PEOPLE
Hollin Bank House Blackburn Road Oswaldtwistle Lancashire BB5 4PE Lead Inspector
Mrs Susan Hargreaves Unannounced Inspection 19th May 2008 10:20 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 Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Hollin Bank House Address Blackburn Road Oswaldtwistle Lancashire BB5 4PE 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) 01254 236841 01254 236841 ray.pullinger@yahoo.co.uk Mr Raymond John Pullinger Mrs Sylvia Pullinger vacant post Care Home 14 Category(ies) of Dementia - over 65 years of age (1), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (1), Old age, not falling within any other category (11) Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. In annexe 2 the number of service users in each category is 11 OP, 1 MD(E) 1 MD and 1 DE(E) 4th September 2007 Date of last inspection Brief Description of the Service: Hollin Bank House offers 24-hour personal care for up to 14 people. The service has been registered as a care home, providing care for over 20 years, by the same registered owners. The home is a detached property set in a residential area approximately one quarter of a mile from Oswaldtwistle town centre. The home is close to a main road that is serviced by public transport. Accommodation is provided in single or twin-bedded rooms. A stair lift facilitates access to all areas of the home. Communal lounges and dining room are located on the ground floor. The current fees charged at Hollin Bank House are £346 to £439.50 per week. Additional charges are payable for hairdressing dry-cleaning and personal items. A copy of the statement of purpose and service user guide is available on request. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes.
A key unannounced inspection, which included a visit to the home, was conducted at Hollin Bank House on the 19th May 2008. No additional have been made since the last inspection. One completed survey was received from a resident and six from the relatives of residents. The manager completed an annual quality assurance assessment several weeks before the visit to the home. This document provided important information about how the home is being managed. At the time of this inspection twelve residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the manager and the area manager regarding issues raised during the inspection. What the service does well:
All residents were visited and assessed before they came to live at the home. A recently admitted resident said, “I’m settling in, the staff are very good.” Members of staff were observed attending to residents in a polite and friendly manner. One resident said, “The staff are very nice.” Another resident said, “We get on alright me and the staff. I’m well looked after.” The relative of a resident who completed a survey commented that the home was friendly, homely and the food was good. Residents said the daily routine was flexible and they could get up and go to bed when they wanted to do. One lady said, “There’s no set time for bed.” Residents said their visitors were welcomed into the home at anytime and offered refreshments. All the residents asked said the meals were good. One lady said, “I enjoy my food.” Another resident said, “The meals are very good.” Training for all members of staff is actively encouraged. Most of the care workers have NVQ qualifications at level 2 or above. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better:
When it is written in a care plan that members of staff should observe a diabetic resident for signs of ‘hyper and hypo’ clear guidance should be given about what this means including the signs and symptoms and the action to take if either of these occur. This will ensure that members of staff follow correct procedure to ensure the resident receives appropriate treatment. To ensure residents are cared for safely the care plan of any resident must not instruct members of staff to use an unsafe moving and handling procedure. Urgent action must be taken to improve the management of medication in order to prevent mistakes being made. An accurate record must be made of the date and time medication is administered to each resident. If medication is omitted a reason for this must be recorded. A record of the receipt of all medication must be kept. All handwritten instructions on the medication administration records should be signed and witnessed. Clear written instructions should be in place for staff to follow to ensure medication prescribed ‘when required’ is given correctly. Medication must be given to residents at the right time in relation to food and other prescribed medication. Failure to so could seriously affect the health and wellbeing of the resident. To ensure medication is managed correctly a system must be put in place to regularly audit all aspects of the management of medication including staff competence. It is important to provide the support necessary to enable residents to have a fulfilling lifestyle. A range of suitable leisure activities must be organised for the residents. Action must be taken to ensure all complaints are properly investigated and resolved. A written record of the complaint, the investigation and the action taken must be made.
Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 7 It is of concern that recruitment procedures are not thorough enough to safeguard residents from the employment of unsuitable staff. Two written references one of which should be from the last employer must be obtained and applicants must complete a health questionnaire and an application form, which includes a full employment history, before they start working at the home. The manager must ensure the home is run in a manner, which promotes the health and safety of all residents. This includes ensuring the National Minimum Standards are met. Failure to address a requirement made on two previous occasions to use only approved, safe, moving and handling procedures is of serious concern. Urgent action must be taken to ensure correct methods are always used in order to prevent serious injury to both residents and staff. To promote the health and safety of residents and staff an up to date gas safety certificate must be obtained. 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. The summary of this inspection report can be made available in other formats on request. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough admissions procedure ensured sufficient information was obtained in order to identify the needs of each resident. EVIDENCE: A copy of the statement of purpose and service user guide is available to prospective residents and their relatives on request. These provide information about the care and facilities provided at the home. The manager or a senior member of staff visited and assessed prospective residents in hospital or their own home prior to admission. The care records of a resident recently admitted to the home included a pre-admission assessment. This assessment provided important information for the care plan. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 10 Residents or their relatives received confirmation in writing that their needs could be met at the home. Standard 6 is not applicable to this service. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents individual care needs were identified and their privacy and dignity promoted. Deficiencies in the management of medication could affect the health and wellbeing of some residents. EVIDENCE: The individual care plans of two residents were inspected. These care plans identified the personal and healthcare needs of each resident and gave directions for staff to follow to ensure their individual needs were met. However, the care plan for one resident suffering from diabetes asked staff to observe for ‘hypo or hyper attacks’ without explaining what the signs and symptoms of these were or the action to take if either of these occurred. One member of staff was asked what she understood by ‘hypo’ and did not know what it meant. A lack of information and knowledge of hyperglycaemia and hypoglycaemia could put residents suffering from diabetes at risk. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 12 Appropriate risk assessments including ones for falls, nutrition and the development of pressure sores were in place. Information for staff about how to manage identified risks was also included in the care plans. One care plan stated the resident prefers the underarm lift with two carers and the use of the hoist would not be acceptable. This care plan also asks members of staff to be extra careful, to work together to minimise the risk to the resident and themselves because they are using an unorthodox procedure. Care workers must not be asked to use a moving and handling technique which is considered unsafe and puts the resident and members of staff at risk of injury. Care plans and risk assessments were reviewed monthly and any changes to the care needed were recorded. The resident signed the review sheet to indicate their agreement with the care provided. A written report about the care given to individual residents was completed during each shift. There were records of the involvement of GP’s and other healthcare professionals in the care of the residents. These included the chiropodist and district nurse. Medication was stored correctly and administered by appropriately trained members of staff. However, a record of the receipt of medication was not made and handwritten instructions on the medication administration records were not signed or witnessed. On numerous occasions care workers had not signed the medication administration records to indicate medication had been given to the resident and a reason for its omission was not recorded. According to one medication administration record ointment was omitted because the resident had nausea. Failure to keep accurate records of the management and administration of medication can result in mistakes being made. It was clear from the medication administration record for one resident that medication was given at breakfast time when the instructions stated it should be taken on an empty stomach. Moreover, this medication was also given at the same time as another medicine when the instructions stated they should not be taken at the same time. Giving one medication at the same time as another contrary to the instructions and at the wrong time in relation to food can seriously affect the health and wellbeing of the resident. The criteria for the administration of medication prescribed ‘when required’ did not provide detailed instructions for staff to follow to ensure residents received their medication only when they needed it.
Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 13 There was no evidence to suggest that the manager or a senior member of staff audited the management of medication in order to identify poor practice, any mistakes and check the competence of members of staff responsible for the administration of medication. To prevent the misuse of medication a record of all medication returned to the pharmacy was kept. Personal care was carried out in the privacy of the resident’s own room or the bathroom. Members of staff were observed attending to residents in a polite and friendly manner. One resident said, “All the staff are very nice.” Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ decisions were respected but the range of leisure activities provided did not meet the needs of some residents. Meals were wholesome and appetising and residents enjoyed them. EVIDENCE: Discussion with residents and staff confirmed that only a very limited range of activities were organised at the home. One resident said, “We don’t have concerts very often. We used to play cards and dominoes but most of them won’t.” One lady said, “They’re long days just sitting here, there’s not much on television. Sometimes a singer comes in.” Another resident said they sang hymns when the Vicar came. One resident said she liked reading and attended the Inskip Club on one evening every week. A member of staff explained that several residents followed their own interests, which included reading and doing puzzles. She also said that residents had their hair and nails done and sat outside when the weather was nice. Two ladies who were sitting in the small lounge were knitting and said that was what they enjoyed doing.
Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 15 Regular contact for residents with their family and friends was considered to be an important part of their life. Residents said their visitors were welcomed into the home at anytime and offered refreshments. Residents said the daily routine was flexible. One resident said, “There’s no set time for bed, I usually go about 8.30pm.” The meal served at lunchtime looked wholesome and appetising. Lunch was unhurried allowing residents time to chat and enjoy their meal. A member of staff was observed feeding a resident in a patient and caring manner. Another member of staff explained that she was liquidising the meat vegetables together for one lady because she did not like the vegetables if they were liquidised separately. All the residents asked said the meals were good. One resident said, “I enjoy my food.” Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents felt able to express their concerns. However, not all complaints were investigated properly resulting in a lack of action being taken to resolve the problem. Staff had the training necessary to ensure residents were protected from abuse. EVIDENCE: A copy of the complaints procedure was displayed in the home and included in the statement of purpose and service user guide. The resident who completed the survey stated they knew how to make a complaint, one resident said, “I’d tell them if I’d anything to grumble about.” Since the last inspection the manager has investigated four complaints. A register listing these complaints was kept. One complaint was made directly to the Commission about the use of inappropriate moving and handling techniques. The manager was asked to investigate this issue. However, there was no documentary evidence that an investigation had taken place. It was also evident that no action had been taken to resolve this issue because the inappropriate underarm drag lift was observed being used during the inspection. Policies and procedures about the safeguarding of vulnerable adults were in place. Discussion with two members of staff confirmed they had received
Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 17 training in safeguarding vulnerable adults. They also knew what to do if allegations of abuse were made. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The premises were well maintained and provided a comfortable and homely environment for the residents. EVIDENCE: At the time of the inspection the home was clean, tidy and well maintained. This provided a safe and comfortable environment for the residents. One resident said he liked his room and it was clean and tidy. The resident who completed the survey stated the home was always clean. Residents were encouraged to bring personal items for their bedrooms to make them more homely. These included, ornaments, photographs etc. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 19 The grounds and gardens were well kept and accessible to residents if they wished to sit outside when the weather permitted. All the laundry was done at the home. A suitably equipped laundry room ensured clothes were washed promptly and returned to the residents. Gloves and aprons were available for staff to protect them and the residents from infection. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Members of staff were encouraged to acquire the skills and knowledge necessary in order to meet the needs of the residents. Recruitment procedures did not fully protect residents. EVIDENCE: The duty rota provided information about the grades and numbers of staff on duty for each shift. The resident who completed the survey stated that staff was always available when needed. It was evident from discussion with members of staff and the manager that training was encouraged. This included induction training for new employees, moving and handling, basic food hygiene, fire prevention, first aid, management of medication and safeguarding vulnerable adults. To ensure members of staff remained up to date and increased their knowledge a programme of training was in place for this year. This included, basic food hygiene, first aid, infection control and medication. Thirteen members of staff (72 ) have NVQ qualifications at level 2 or above. In addition to this a further three members of staff are working towards NVQ level 2. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 21 The file of one member of staff appointed since the last inspection was examined. This file indicated that all the required pre-employment checks to ensure protection of the residents had not been completed prior to appointment. The application form had been completed after she had started working at the home and the health questionnaire two months later. In addition to this only one written reference had been obtained and this was from a family friend. Details of previous employment were not recorded on the application form and there was no evidence to suggest that references had been requested from the referees stated. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 22 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Management arrangements do not ensure the health and safety of residents is promoted nor do they ensure the national minimum standards are met. EVIDENCE: The manager is a registered nurse with many years experience of managing a care home. He maintains an up to date knowledge of current practice by attending relevant seminars and reading articles in a variety of care publications. However, after lunch members of staff were observed using the incorrect and dangerous underarm lift to transfer three residents from their wheelchairs into armchairs. Although a hoist was available but members of staff were unable to use it because they had not received any training. The manager said one
Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 23 lady would find using a hoist unacceptable. The care plan for this resident stated she preferred the underarm lift and had signed a statement agreeing to the use of this unsafe method. It is of serious concern that the manager has failed to comply with a requirement made at the last two inspections to address this issue and continues to put staff and residents at risk of injury by allowing the use of the underarm drag lift. The home has achieved the nationally accredited Investors in People award. Residents and their relatives had been asked to express their views about the care and facilities provided by completing satisfaction questionnaires at the beginning of May 2008. The comments written on the two completed ones available were positive. Residents were also encouraged to express their views at the regular resident’s meetings. At a recent meeting meals, entertainment and the new care plans were discussed. The manager with the agreement of individual residents or their relatives assisted with the management of their finances. Records of transactions involving residents’ money were seen to be up to date. Policies and procedures for safe working practices were in place. These help to make sure the home is a safe place for residents to live. Fire alarms and emergency lighting were tested weekly. Fire drills took place frequently and a staff attendance record was kept. An up to date fire risk assessment was in place. Records of the routine servicing of equipment were seen. These included an up to date electrical installation certificate and evidence that the testing of small electrical appliances had taken place in February 2008. However, the gas safety certificate, which must be renewed annually, was dated 25 January 2006. Records maintained in the kitchen included, fridge, freezer and food temperatures. This ensures food is stored correctly and handled safely. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 24 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 25 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 OP7 Standard Regulation 12(1)(a) (b) Requirement To make sure members of staff are aware of the signs of hypoglycaemia and the action to take if this occurs clear directions must be written in the care plan of any resident at risk of developing this condition. To ensure residents are cared for safely the care plan of any resident must not instruct members of staff to use an unsafe moving and handling procedure. To prevent medication errors an accurate record must be made of the date and time medication is administered to each resident. If medication is omitted a reason for this must be recorded. A record of the receipt of all medication must be kept. Medication must be given to residents at the right time in relation to food and other prescribed medication. Failure to so could seriously affect the health and wellbeing of the resident. Timescale for action 27/06/08 2 OP9 Schedule 3 17(1)(a) 3(i) 27/06/08 3 OP9 13(2) 13/06/08 Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 26 4 OP9 24(1) 5 OP12 6 OP16 7 OP29 16(2)(m) (n) 22(3) 19(1)(b) schedule 2 8 OP31 10(1) 9 OP38 10 OP38 13(4)(a) 13(4)(c) To ensure medication is managed correctly a system must be put in place to regularly audit all aspects of the management of medication including staff competence. To enable residents to have a fulfilling lifestyle a range of suitable leisure activities must be organised. To ensure complaints are resolved a written record of the complaint, the investigation and the action taken must be made. In order to safeguard residents from abuse two written references one of which should be from the last employer must be obtained. Applicants must also complete an application form, which includes a full employment history, and complete a health questionnaire before they start working at the home. The manager must ensure the home is run in a manner, which promotes the health and safety of all residents. The manager must also ensure the National Minimum Standards are met. To promote the health and safety of residents and staff an up to date gas safety certificate must be obtained. To prevent injury to residents all members of staff must receive training in the use of moving and handling equipment and ensure approved, safe moving and handling procedures are always be used. Timescale of 21/08/06 and 28/09/07 not met. 27/06/08 25/07/08 27/06/08 13/06/08 27/06/08 25/07/08 27/06/08 Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 27 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. OP9 2 OP9 Refer to Standard Good Practice Recommendations All handwritten instructions on the medication administration records should be signed and witnessed Clear written instructions should be in place for staff to follow to ensure medication prescribed ‘when required’ is given correctly. Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hollin Bank House DS0000009433.V360011.R01.S.doc Version 5.2 Page 29 - 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!
