Inspection on 08/09/05 for Holmwood Care Centre

This inspection was carried out on 8th September 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

Holmwood Care Centre 31/03/10

Holmwood Care Centre 16/03/10

Holmwood Care Centre 13/08/09

Holmwood Care Centre 18/07/07

Holmwood Care Centre 25/07/06

Holmwood Care Centre 06/10/04

Holmwood Care Centre 21/05/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Maple Lodge

Polesworth Group 32 Station Road

Heathlands

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

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

CARE HOMES FOR OLDER PEOPLE Holmwood Care Centre 25 Comberton Road Kidderminster Worcestershire DY10 3DJ Lead Inspector Mandy Burton Unannounced 8 September 2005 08:35 am 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. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Holmwood Care Centre Address 25 Comberton Road, Kidderminster, Worcestershire DY10 3DJ 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) 01562 824496 St Cloud Care Plc Angela Jean Whiston Care Home with Nursing 60 Category(ies) of DE(E) Dementia over 65 (40) registration, with number LD(E) Learning disability over 65 (1) of places OP Old age (60) PD Physical disability (5) PD(E) Physical disability 0ver 65 (60) TI Terminally ill (4) Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Accommodation to be used for a maximum of 30 nursing places. 2. Category PD is restricted to persons aged between 55-64 years Date of last inspection 6th October 2004 Brief Description of the Service: Holmwood Care Centre is a 60 bedded care home situated a short distance from the centre of Kidderminster. The home has 52 single rooms 43 of which have ensuite faciliites and there are 4 shared rooms. Accommodation is provided on three floors with a passenger lift providing access to rooms on the upper floors. The home provides both residential and nursing care, with a maximum of 30 residents requiring nursing care to be accommodated at any time. Residents requiring nursing care are usually cared for on the ground and first floor with residents requiring residential care located on first and second floors. The home is one of six care homes owned by St Cloud care Plc. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 08.35am. It took place over a period of seven hours. The main focus of this inspection was to review standards of care for residents living in the home, and to review requirements set at the home’s previous inspection. A partial tour of the home took place and a selection of care, medication administration, health and safety and personnel records were examined. Six residents and seven members of staff were spoken to during the course of this visit. What the service does well: What has improved since the last inspection? 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. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 6 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 Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 7 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) 4 Residents are cared for by a team of staff who have a good understanding of each resident’s individual needs and preferences. EVIDENCE: It was evident from observations made and discussions with residents and staff that staff in the home have a good understanding of the needs and preference of each resident. One resident described staff in the home as ‘ever so good, they will do everything for you’. Since the last inspection there has been change to the homes conditions of registration and the maximum number of nursing places at any one time has increased to 30. On the day of this inspection 29 of the 58 residents were receiving nursing care. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 8 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 Inaccuracies in care planning and healthcare systems do not provide residents with the assurance that their individual care needs will always be met by staff and have the potential to place them at risk. Systems for the administration of medication are good but shortfalls in recordkeeping could lead to errors in administration and therefore place residents at risk. EVIDENCE: A selection of care records were examined. Care plans were in place for each resident. There was very limited evidence that residents were involved in planning their care. Corporate pre printed care plans are used which require staff to enter the name of each resident and add or delete information as applicable to the needs of each person. The current format of these care plans leaves little scope for personalisation. In addition to this the lack of detail in some cases provided potentially misleading information when describing the care to be provided to a specific resident. St Cloud Care proposes to change this system in the near future . Shortfalls included: Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 9 • • • • • • The plan for one resident referred to then requiring weekly baths. Discussions held with senior staff indicated that this was no longer appropriate for that resident. One resident had multiple wounds, which were being primarily treated by visiting district nurses, with senior carers providing additional support as directed. No care plan was in place to support practice by care staff. A care plan for one resident referred to the fact that the resident had an infection, the plan made no reference to infection control measures that would be necessary. Records were examined in relation to a resident with impaired vision. There was limited acknowledgement in care documentation of the resident’s visual impairment and the implications for staff when providing personal care and day-to-day support. Records showed that one resident had history of confusion and needed to be safeguarded from harm. While it was clear staff were aware of the situation and meeting the residents needs in care practice, there was no reference to support this at all in their individual care documentation. There was very limited evidence to demonstrate that social and emotional needs of residents had been taken into consideration and appropriate support identified to meet those needs. Regular healthcare screening is undertaken for each resident, which ensures early detection of any potential health care problems. It was however apparent that care plans had not always been initiated for all residents when identified at risk of developing pressure sores. Discussion took place about the need to improve recording in relation to wound care management and to ensure individual records are kept in relation to the status and assessment of each wound and, the plan of care including current treatment. A selection of medication administration records were seen in order to review requirements made at the previous inspection. While systems for the administration of medication are good the quality of record keeping was variable. Not all written additions or amendments to records had been signed/countersigned by the person responsible for changing documentation and the reason for any omissions was not always denoted. One resident was prescribed medication four times a day and records seen showed that they had only received it three times a day with no reason given for the omission. In addition to this where doses on a prescription record were defined, as 1 or 2 tablets, staff were not always specifying how many had been given each time. Staff observed during this visit demonstrated good practice in promoting the privacy of each resident in their care. Privacy screening is in place in shared bedrooms. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 10 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. Residents are supported to participate in a range of social and recreational opportunities within the home but any opportunities to spend time outside the home and within the local community are very limited. The home’s menu is not sufficiently varied to ensure the dietary needs and preferences of all residents can be met. EVIDENCE: Residents spoken to were able to confirm that they were able to make choices in respect of daily living and spoke about choosing where and how they wish to spend their time. The home has a diversional therapist who is employed on a part time basis. All residents are provided with written details of the monthly programme of activities and events, which they can attend if they wish to do so. In addition to this the therapist spends time each morning doing ‘room visits’ where one to one attention is given to a selection of residents. Typical interaction includes, chatting, writing or reading letters, reading out books or magazines, walking around the grounds etc Basic records are kept of activities and events that take place but there was little evidence to show that the social and recreational needs and preferences of each resident had been assessed and records of how residents in the home spent their days. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 11 It was reported that a limited budget is available for any resources and entertainment and therefore ongoing fundraising is necessary. This is usually in the form of raffles, which take place throughout the year. It was reported that a future project is to raise funds to provide residents with a DVD or video library. Opportunities for trips or excursions away from the home are rare but some residents reportedly attend pre arranged local groups and societies and day care services as desired. At the commencement of this inspection, residents were observed taking breakfast in their own rooms. It was noted that a selection of food was made available which included a cooked breakfast. Staff were observed serving breakfast to residents and taking time to speak with them to check they had everything they required. Residents spoken to were generally positive about the meals provided and the choices made available to them. One resident said meals were ‘very nice’ and said that it seemed like they were always eating. Another resident spoke of the pleasant dining facilities available to them. It was reported that each day residents are consulted about their choice of meal for the following day. Residents spoken to were however unable to recall the meal they had ordered. A member of staff spoken to said that they would not typically know what the meal was until it was served from the kitchen. Tables in the dining rooms had been laid ready for lunch. Tables in the large dining area were laid with cloths, which matched seating and had a small vase containing a flower in the centre of each table. In addition to this tables were laid with, cutlery, condiments, and drinking glasses. Tables in the adjacent area had tablecloths, cutlery and coloured plastic tumblers. Staff reported that this area was used for residents in the nursing wing. At lunchtime 7 residents were seen sat in wheelchairs at these tables. When asked why these residents did not have drinking glasses and access to condiments like other residents, staff reported that it was because the residents were ‘nursing’ and it was always done like this and another member of staff reported that some residents may drop the glasses. Staff were however allocated to this area at mealtimes to supervise and support residents. Discussions took place about more effective ways to promote the dignity and independence of residents in this area at mealtimes. The kitchen was seen. Appropriate written records had been kept of food probe temperatures and fridge and freezer temperatures. The home’s menus were examined. The menu seen was the ‘summer menu’. The menu showed two basic choices of main course each day at lunchtime with the exception of the Sunday dinner, which was always a roast dinner. The second choice each day was varying types of salad. Residents who required soft diets were only able to have the main meal as their choice. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 12 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) These standards were not assessed. EVIDENCE: During the course of this inspection a complaint received by the Commission for Social Care Inspection was brought to the attention of the deputy matron, elements of which were investigated during this visit. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 13 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, 22, 23, 24, 25 and 26 The general standard of the environment within this home is satisfactory providing residents with a comfortable place to live. Inappropriate storage arrangements and poor practice in relation to the management of infections have the potential to place residents in the home at risk. EVIDENCE: During this visit a partial tour of the home took place. The home was noted to be generally well maintained internally and externally. There were however several issues which required attention: • A glass wall light fitting in one corridor was noted to have been broken and would have been hazardous if touched. This was brought to the attention of the nurse in charge and was made safe. • The door to one bathroom was not able to close properly, without force and required attention. • During a walk round the home a second floor bathroom was observed. The condition of the bathroom was poor, the room was malodorous, the light was not working and it was noted to contain several pieces of equipment including a pressure relieving mattress and wheelchair. Access to both the toilet and the wash hand basin were restricted by the Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 14 • equipment. This matter was brought to the attention of the nurse in charge and the equipment removed and the room cleaned before the inspection ended. Equipment was being stored in a number of other bathrooms, limiting access by residents. The home has however created an additional storage area on the first floor, and some equipment had been placed there, with further space available. Staff in the home have access to a number of aids for the safe moving and handling of residents. Two lifting aids were observed stored in a hairdressing room, one of which, a stand aid had been out of action for over 10 days and awaiting repair. In addition to this both aids were noted to be in need of cleaning. Repairs to the stand aid were completed by the end of this inspection. At a previous inspection staff referred to the fact they would benefit from having an additional stand aid available to them. Discussions with staff indicate that they still feel a need for this . Bedrooms seen were very personalised, with evidence that residents had been able to bring personal item with them into the home. Since the last inspection two single ensuite rooms have been upgraded and refurbished and have been designated as ‘premier’ rooms. The rooms were very attractive and had been furnished to a good standard. All rooms accessible to residents are fitted with a nurse call system. There was no evidence to support how residents unable to use this system were being kept safe. The laundry facilities were seen and noted to be adequate for the service. The laundry is staffed every day. The area appeared to be clean and well managed and appropriate infection control measures were in place. Some action is necessary however to improve practice in relation to infection control measures in other areas of the home. During tour of the home several tablets of soap were observed in communal bathroom and toilet facilities. In addition to this it was noted that an incontinent pad had been inappropriately disposed of. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 While adequate numbers of staff are on duty there is no assurance that all staff in the home are suitably trained and have the necessary knowledge to meet the individual needs of residents and ensure their safety. Failures in recruitment practices are not ensuring safeguards are in place to offer protection to residents living in the home. EVIDENCE: On the morning of this inspection 58 residents were living in the home and were being cared for by a team of staff comprising of one trained nurse, and ten carer’s one of which was a senior carer and was managing the care of the residents receiving residential care services. The atmosphere within the home was very relaxed and staff were observed caring for residents in a sensitive and caring manner. A staffing rota was documented which recorded the details of the staff on duty 24 hours a day in the home. Typical staffing levels for the home based on full occupancy were one nurse and ten carers during the morning, one nurse and eight carers during the afternoon/evening and one nurse and three carers throughout the night. Policies and procedures are in place in relation to the recruitment of staff. Records seen in relation to one member of staff recently employed in the home showed that they had commenced employment at the home before the Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 16 appropriate personal checks had been carried out. This practice is unsatisfactory and has the potential to place residents living in the home at risk. A staff training matrix completed by the home was seen. Information recorded showed some significant shortfalls in training in relation to fire safety, infection control, moving and handling, food hygiene (catering staff), and COSHH training. In addition to this there was limited evidence of any specialist training being undertaken. This is of particular concern taking into account the home’s categories of registration and in particular their ability to provide care for residents with dementia. There was no evidence that staff in the home had received any training in relation to caring for residents with a dementia related illness. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 17 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) 37 and 38 There is no assurance that staff in this home have received the relevant training in health and safety practices in order to carry out safe working practices and ensure the ongoing safety of residents in their care. EVIDENCE: During recent months the home has been managed by the deputy matron during an unforeseen period of absence by the manager. The home has been managed well during this time, The deputy matron’s main role has primarily been to maintain the day-to-day running of the home and ensure the wellbeing of staff and residents. Time available to address previous requirements has been limited and efforts have therefore been concentrated on more straightforward issues, which can be addressed immediately. Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 18 During this inspection a number of issues in relation to health and safety practices were identified for action: • • • • • The movement of one bedroom fire door was restricted by the positioning of a wardrobe. Three bedroom doors were observed to be wedged open. During tour of the home several tablets of soap were observed in communal bathroom and toilet facilities and an incontinence pad had been inappropriately disposed of. Health and safety risk assessments had been documented but there was insufficient detail of what action was taken when any risk were identified. Records seen showed that not all staff had received up to date training in fire safety, moving and handling and infection control. Written records are kept of all accidents that occur and appropriate action taken by staff at the time of the incident. The kitchen area was clean. Improvements were noted in the consistency recordings of food probe temperatures and fridge and freezer temperatures. A variety of records were seen during this visit, the standard of which was variable. As detailed earlier in the report some improvements are necessary to improve records kept in relation to care planning, medication administration and staff recruitment. , Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 19 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 x x x 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION 2 3 3 2 3 3 2 2 STAFFING Standard No Score 27 3 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x 2 2 Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 20 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 7, 37 Regulation 15 Timescale for action Ensure all residents care plans Immediate accurately detail the specific care and to be provided to meet their ongoing. individual needs. (Previous timescale immediate not met ) Implement systems which Immediate facilitate residents involement in and the care planning process ongoing. wherever possible. Care plans must be initiated for Immediate all residents identified to be at and risk of developing pressure sores ongoing. which detail action to be taken to reduce risks identified. The social and emotional needs Immediate of each resident must be and ongoing. assessed and whenever needs are identified care plans must be initiated which detail how these needs are to be met . 1st A written programme of wound care management must be November developed and implemented 2005 which includes systems for the assessment of wounds and individual plans which include details of the status, size and current treatment of each wound. Staff must sign for medicines Immediate administered and document a and Version 1.40 Page 21 Requirement 2. 7 15 3. 7, 8 12(1) 15 4. 7 12(1) 15 5. 8 12(1) 15 6. 9, 37 13(2) Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc 7. 9, 37 13(2) 8. 9, 37 13(2) 9. 12 12(1) 16 10. 15 12(2),(3) 16(i) 11. 12. 19 22 23 23(2) 13. 22 13(4)(c ) code for omissions. (Previous timescale immediate not met ) Ensure any written additions or amendments to the medication administration records are checked, dated and countersigned by two staff. (Previous timescale immediate not met ) Whenever prescription records indicate a variable dosage, staff must indicate the specifc dose given one each ocassion. The social and recreational needs of each resident must be assesed and documented and plans put in place to demonstrate how these needs are to be met . The registered person must ensure the residents are offered a varied menu at mealtimes which reflects the needs and preferences of each resident. (Previous timescale 1st February 2005 not met) Repairs must be undertaken to the stiff bathroom door identified during the inspection A review storage arrangements must be made and adequate storage must be provided for equipment which avoids the use of bathrooms .(Previous timescale 1st February 2005 not met) The registered providers must ensure all residents who are able to use the call bell system have full access to it at all times. Where a resident is assessed as not able to use the call bell a care plan must be in place which details how the residents safety is to be maintained. This assessment and care plan must be regularly reviewed.(Previous timescale immediate not met) ongoing Immediate and ongoing Immediate and ongoing 1st November 2005 1st November 2005 Immediate Immediate Immediate and ongoing Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 22 14. 15. 26 29, 37 13 16 19 Schedule 2 18 Infection control policies must be adhered to at all times . New staff must not commence employment until all satisfactory checks have been completed as detailed in Schedule 2. All staff must receive up to date training on : Moving and handling, infection control and food hygiene(catering staff). Written records must be kept of all training undertaken . All staff must receive in house training on fire precautions at not less than three monthly intervals . (previous timescale immediate not met ) All staff must receive training on caring for residents with dementia . Written records must be kept of all training undertaken . The homes general risk assessments must accurately detail the measures to be taken to eliminate or reduce any risks identified.(previous timescale 1st January 2005 not met) Fire doors must not be wedged/propped open unless fitted with an appropriate holding device which meets with the requirements of the inspecting fire authority . Immediate and ongoing Immediate and ongoing 1st December 2005 16. 30,38 17. 30, 38 23(4) Immediate and ongoing 1st January 2006 18. 30 18 19. 38 13(4) 1st November 2005 20. 38 23 Immediate and ongoing 21. 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. Refer to Standard 13 Good Practice Recommendations Opportunities for residents to go on trips and excursions E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 23 Holmwood Care Centre 12 2. 3. 4. 5. 15 15 22 33 and to participate in activities and events within the local community should be explored. It is recommended that the details of the daily menu are clearly displayed on each floor to enable residnets and staff to know the meals due to be served . It is strongly recommended that a review of the dining arrangements take place in order to ensure that practices promote the dignity of all residents. A review of the moving and handling aids currently available to staff should be made in order to determine the need for a standing hoist . Strategies should be developed which would enable residents/representatives to affect the way in which the service is delivered. (This standard was not inspected ) Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 24 Commission for Social Care Inspection The Coach House, John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Holmwood Care Centre E52 S4119 Holmwood Care Centre V247431 080905.doc Version 1.40 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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