Inspection on 10/02/06 for Holmwood House

This inspection was carried out on 10th February 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Holmwood House 22/07/09

Holmwood House 25/07/07

Holmwood House 06/06/06

Holmwood House 07/09/05

Holmwood House 22/03/05

Holmwood House 13/10/04

Holmwood House 12/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Holmwood House Channels Hill Westbury On Trym Bristol BS9 3EU Lead Inspector Vanessa Carter Unannounced Inspection 10th February 2006 09:30 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 Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 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. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Holmwood House Address Channels Hill Westbury On Trym Bristol BS9 3EU 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) 0117 9500810 0117 9508070 Mr Ghassan Al-Jibouri Mrs Serena Hogg Lucas Reynolds Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 41 Patients over 50 years of age sickness, injury and infirmity Staffing Notice dated 10/07/1998 applies Manager must be a RN on part 1 or 12 of the NMC Register Date of last inspection 7th September 2005 Brief Description of the Service: Holmwood House is registered to provide nursing care for up to forty-one people who are fifty years and over. The Home is a classically styled property, located in its own grounds, surrounded by residential housing and near to the local shopping centre. There are local shops, public houses and restaurants located within walking distance of the home. There are single and double rooms located on all three floors and a lift provides access to all floors. The home is near to major roads and bus routes. The mission statement describing the aims of the Home was displayed in the entrance hall. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over eight hours, on one day only. The purpose of the visit was to check on progress in meeting the requirements and recommendations made at the last inspection. Evidence was gained from speaking with residents, one visiting relative, care staff, one registered nurse and the homes manager. A tour of the premises, examination of some of the homes records, and observations of staff practices and interactions with the residents have contributed towards this report. Not all standards were inspected and this report should be read in conjunction with others so a fuller picture of the home can be gained. What the service does well: What has improved since the last inspection? Improvements have been made to the appearance of the communal areas of the home, and there is an ongoing programme of redecoration throughout the rest of the home. The recruitment procedures for new staff have been tightened to ensure that unsuitable staff are not employed at the home. The home has also recruited a deputy manager, who will support the manager in the management of the home and the supervision of registered nurse, adaptation nurses, and care staff. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5 Minor improvements must be made to the information given to prospective residents and their representatives, so that they can be clear of what to expect. The homes admission procedures ensure that placement is only offered to those whose needs can be met. EVIDENCE: The home’s Statement of Purpose and Service Users Guide is dated October 2004, however appears to present a true picture of the service and facilities available at the home. Minor amendments are required to the complaints procedure as reference is made to the previous manager. These documents must be kept under review and revised when necessary. Amended documents must be supplied to the CSCI and each resident. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 9 The manager undertakes the pre-admission assessments for all new residents. The majority of residents come to the home after a period of stay in hospital. The home has a comprehensive assessment tool to enable the manager to determine that the home is able to meet the person’s needs. The records of the most recently admitted person were inspected. On the day of inspection, one family visited the home to see if it would meet their relative’s requirements. During the inspection it was evidenced that the manager considers the impact of any new admission upon the existing residents. She explained that she prefers not to admit new persons at the end of the week, over the weekend or late in the day. The reasons for doing this she reported, is to ensure that any placement does not go awry at the point of admission, when access to medical assistance is limited. This is good practice. The home offers placement to older people who need assistance with personal care and nursing tasks. It is only able to accommodate people with low to moderate levels of dementia and confusion. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Improvements must continue with the care planning process. The plans must be regularly reviewed to ensure that the staff provide the care that is needed. Relationships between staff and residents are respectful, and it is obvious the staff know the residents well. Medication systems need some minor improvements to staff practice. EVIDENCE: The care planning files of five residents were examined. The care plans were in general well written and detailed the specific needs of the resident and what actions the care staff were to take. This was particularly so, of those plans written by the manager. The manager was in the process of reviewing all the care plans – many of them had not been reviewed for sometime and this is not acceptable practice. Residents care plans must be reviewed, in consultation with the resident or their representative where appropriate, at least once a month, and then amended to reflect changes in need. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 11 The quality of the wound care planning documentation examined was very poor and did not give clear instructions for staff or provide clear evidence of progress or deterioration. Photographs of wounds were dated but not named, and two seen were of such poor quality, that the picture did not clearly show the wound. The manager must address this shortfall with the staff and ensure that all records are accurate and clearly maintained. Discussions with some of the staff evidenced that they are knowledgeable regarding the differing needs of each of the residents and whilst this is reassuring, the care plans did not reflect this information. Risk assessments are completed in relation to falling and the potential to develop pressure sores, but the manager explained that they do not complete nutritional assessments as normal practice. The home currently has no assessment tool available to do this but the manager stated that one could be obtained. The home must complete nutritional assessments on all residents upon admission and then periodically. Where needs are identified, a plan of care must be written detailing actions that the staff must take. Daily records are completed for each resident but the quality of the recording varies. The manager must ensure that registered nurses make clear and accurate notes and that all entries contain a full signature, in line with good record keeping guidelines. Two examples were seen where “tippex” had been used in resident’s notes - this was discussed with the manager. As referred to in the last CSCI report, there is a developmental need for some of the trained nurses, in relation to record keeping. Records evidence that the residents have access to other healthcare professionals, examples include GP’s, chiropodists, primary healthcare staff and the speech and language therapist. Residents are able to choose who their GP is however the majority are registered with one practice. The home uses a blister pack system for the majority of their medications, and observations were made of the safe practice of one medicine round. Some minor improvements must be made however to the home’s systems. Two nurses must always sign when handwritten medication administration sheets are completed. The newly appointed deputy manager will be taking responsibility for the ordering and disposal of medications, and this will be a focus of the next inspection. Care assistants were observed interacting with residents in a respectful and friendly manner, and it was obvious from discussions with some of the staff that they knew the resident’s likes and dislikes. They were attentive and responded well when one person became distressed. In general residents are referred to by their first name. Each of the residents was nicely dressed and one lady commented that she had recently had her hair set. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Residents are able to have visitors as and when they are able, and are assisted to have a say in how they spend their time. Improvements are needed to ensure that residents are provided with meaningful activities. Residents are offered choice in what to eat and are provided with a well balanced diet. EVIDENCE: The home has a weekly plan of activities and this is displayed around the home. On the day of the inspection, “quizzes, baking, games and reminiscence therapy” were planned; however, there were no such activities taking place. One resident said it was “very boring” and that she spent her time watching TV. The TV in one of the lounges was showing cartoons and when asked, none of the residents were watching the programme. Another resident said that he chose not to participate in any of the activities and that they weren’t “his cup of tea”. There were pictures displayed in the hallway of recent Christmas activities. Improvements must be made in the way in which the home meets the social care needs for each resident. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 13 Those residents who were able were seen moving independently around the home using their walking aids, and others were asked where they wanted to spend their time. One visitor said they were able to visit their relatives at any time, and generally do this on a daily basis around the lunchtime period. Another person said their family lived nearby and visited often. There is a choice of two main meals at lunchtime and residents were heard being encouraged to make choices about what they wanted to eat. The meals were attractively served, on newly purchased crockery. Cold drinks were provided with the meal. A number of residents need to be assisted with feeding and this was undertaken sensitively and in an unhurried manner. There was evidence that a number of residents had specific dietary needs, yet nutritional assessments are not undertaken. The home must have processes in place to ensure that nutritional needs are met and that, where necessary, there are systems in place to monitor residents’ likes and dislikes, dietary intake and weight loss. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this section were assessed on this inspection. EVIDENCE: Despite the standards not being assessed, the following information was noted: • • The home’s complaints procedure needs to be updated to include the name of the new home manager The manager arranges teaching sessions each Friday afternoon. The week following this inspection, protection of vulnerable adult (POVA) training is planned. However, these sessions are not attended by all staff and will often be cancelled. Staff knowledge and awareness of their responsibilities will be a focus of the next inspection. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, and 26 Resident’s live in an environment that is clean and homely, and fully equipped to meet their needs. Improvements have been made to the decoration of some parts of the home, resulting in a much more pleasing environment. EVIDENCE: Holmwood House is a period property, situated within it’s own large gardens. The gardens are established, well maintained and provide a safe and quiet space for residents to relax in. One resident said that she liked to sit and watch the birds, squirrels and badgers in the gardens. The front entrance is secured with a key-padded lock, and leads into a pleasant reception area. It has retained the period wood- panelling, has seating areas for visitors and residents, a pay phone, and is the main thoroughfare for the home. The staircase leads off the reception area to the first floor. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 16 The communal areas are all on the ground floor. There are two linked dining rooms, one conservatory overlooking the rear gardens, and two separate lounges. Each of the rooms are equipped with comfortable furniture and finished with nice soft furnishings. Both lounges have benefited from being recently decorated. At the last inspection it was noted that there was large crack in the plasterwork in the large lounge – this has been rectified. Some of the paintwork in the home is marked but there is an ongoing programme of redecoration. The manager explained that bedrooms are decorated, the carpets and curtains cleaned, in between residents. There are a number of toilets and bathrooms located throughout the home in sufficient numbers to meet the needs of the residents. There are specialist bathroom facilities to enable those residents with mobility difficulties, or who are frail, to be assisted to have a bath. The home has 31 bedrooms, ten of which are for shared occupancy. The bedrooms are located on the three floors and a lift makes them all accessible rooms. Most of the bedrooms were viewed. Residents are encouraged to bring in small items of their own furniture to make their rooms familiar and more homely. A number of the bedrooms have ensuite facilities and those that don’t, have a vanity unit. Each bedroom is provided with its own commode, with two for shared rooms. A requirement was made after the last inspection that a planned programme of installing bedroom door locks is instigated - this has not been started. Discussion took place with the manager around the appropriateness of door locks for the residents, however she had no evidence that the residents or their representatives would not wish to be able to lock their bedrooms. It has been agreed that the manager will consult with all residents/representatives, and will arrange for the locks to be fitted for these people. As part of the admission process, these views should be sought as part of the assessment process. In order for residents to be able to keep their personal possessions secure, the home must provide a lockable drawer with key. The home was clean and tidy and generally free from unpleasant odours, apart from the sluice rooms where there was a noticeable smell of bleaching agents. Care staff must ensure that used bed linen is disposed of appropriately – a linen skip was piled high, and this does not evidence safe working practice. Alcohol gel was placed around the home as means of preventing the spread of infection and care staff were seen to be using this. The laundry room consists of two commercial washing machines and two large tumble driers, and this is adequate to meet the needs of residents. The laundry door continues to be propped open while the laundry staff are present, but is shut at all other times. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 29 Residents can be re-assured that they will be looked after by staff who are skilled and able to meet their needs. Improvements to the homes recruitment procedures will ensure that the vulnerable residents are safeguarded and protected. EVIDENCE: On the day of inspection there was one registered nurse and six care assistants on duty. The manager was also on duty but was undertaking management duties rather than clinical work. Since the last inspection, a deputy manager has been employed and she is currently completing her induction programme. In order to meet all of the resident’s daily living needs, the care staff are supported by designated ancillary staff – the chef, administrators, housekeeping and laundry staff. The staffing levels appear to be sufficient to meet with the needs of those residents currently accommodated. The manager explained that some of the ‘adaptation nurses’ who work at the home, and are in the process of working towards NMC registration, require additional training, supervision and support from her. She discussed the issues involved and the actions she is taking, to improve these workers performance. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 18 Six care staff have either attained, or are in the process of obtaining, National Vocational Qualifications at Level 2. A number of overseas staff who are registered nurses in their own country are considered as having qualifications equivalent to an NVQ Level 2. In addition one staff member is doing the NVQ level 3, and fulfils a senior care assistant role. The personal files of five staff members were examined. Improvements have been made to the homes recruitment procedures – an application form, two written references and evidence that CRB and POVAfirst checks had been carried out prior to the start of employment, were filed. The homes training plan was not discussed on this inspection, and will be a focus of the next visit. The manager arranges weekly training sessions and those currently planned are manual handling, privacy and dignity, elder abuse and the policies of Holmwood House. However, these are often postponed and staff reported that not all staff attend. The manager needs to ensure that the whole staff team remain up to date and aware of all current issues. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36, 37 and 38 Residents live in a home that is well managed and run with their best interests in mind, however staff do not always ensure that safe working practices are used. This has the potential to place residents at risk of injury. Improvements are required in the homes standard of record keeping. EVIDENCE: The manager is a registered nurse and has been at Holmwood House for just under two years. She previously worked as the registered manager at a sister home. Since the last inspection, the manager has completed the Registered Managers Award. She demonstrated good awareness of the residents needs, the staff capabilities and of her responsibilities as the registered manager. She cooperated during the inspection process and demonstrated an awareness of the homes shortfalls. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 20 Staff spoke positively about the manager’s management style and the support they receive from her. Staff meetings are held on a regular basis, but again, not all staff attend them. The manager interacted well with the residents and was observed giving clear instruction and guidance to the staff team Staff confirmed that they have formal supervision and the records were seen. Arrangements for regular two monthly sessions have fallen by the wayside recently, but appear to now be back on track. The manager completes all formal supervision sessions, but the plan is that the task will be split between herself and the deputy manager. The manager must ensure that all the home records are maintained correctly in line with record keeping guidelines. For each resident an accurate record of the care delivered must be recorded, but this cannot just be the responsibility of the manager. Whilst it is the manager’s responsibility that the records are maintained, registered nurses must be accountable for their own actions and keep records in respect of their work in line with the NMC ‘guidelines for records and record keeping’. The fire logbook evidenced that tests and checks of the system are taking place at the appropriate intervals, however it is recommended that historical information is removed to make the information is easier to find. An updated workplace fire risk assessment was completed in November 2005, however no progress has yet been made on the 10 requirements made by the fire officer. The home has a number of hoists, and specialist bathing equipment, and these were being serviced on the day of inspection. This is in compliance with a requirement made at the last inspection. This equipment must be serviced again, according to the manufactures guidelines. The manager gave assurance that all other service contracts were up to date but this will be checked at the next inspection. A number of residents have bed rails installed in order to maintain their safety whilst they are in bed. However, the home has installed inappropriate equipment that has the potential to be an added risk to the resident. The height of the bed rails does not afford sufficient security. The home must ensure that the following actions take place: • risk assessments must be undertaken to ensure that bed rails are the most appropriate method of keeping a resident safe whilst in bed • consent must be obtained prior to their use from either the resident or their representative • bed rails must be compatible with the bed and mattress height • bed rails must be correctly fitted and positioned • bed rails must be regularly maintained • risk assessments should remain under constant review, particularly at times of changing circumstances. Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 X 3 2 X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 3 2 1 Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? NO 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 OP1 Regulation 4(1) Timescale for action The homes Statement of Purpose 10/03/06 must be updated to reflect the changes. A copy to be supplied to the Commission and be available for residents/visitors to view. All assessments and care plans must detail specific action for staff to follow and be regularly reviewed with the resident/ representative (The previous timescale of 30/11/05 has not been met) Requirement 2. OP7 15 10/03/06 3. OP7 12 Wound Care Plans must be clear 01/03/06 and show meaningful evidence of monitoring, highlighting deterioration or progress. Nutritional assessments must be completed on all residents, to ensure that any needs are identified and an appropriate plan of action prescribed. A programme of activities must be provided that meets the needs of the residents. 10/03/06 4. OP8 14(1,2) 5. OP12 16(2) n 10/06/06 Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 23 6. OP24 12(4)(a) Consult with the residents regarding bedroom door locks and implement a planned programme of installation for those residents who want one. (The previous timescale of 30/11/05 has not been met) 10/03/06 Locks to be fitted to other rooms, as and when they become vacant. 7. OP24 23(2) m Resident to be provided with a lockable drawer in their bedroom for storage of personal effects. Staff must follow safe working practice in the handling and disposal of used bed linen in order to control the spread of infection. Records kept in respects of each resident must be accurate, up to date and maintained in accordance with good record keeping guidelines The home must ensure that the use of bed rails follows safe working practices and adheres to health and safety legislation. 10/06/06 8. OP26 13(3) 10/03/06 9. OP37 17(2) 10/03/06 10. OP38 13(7) 10/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Holmwood House DS0000020280.V283721.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 House DS0000020280.V283721.R01.S.doc Version 5.1 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. 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!