Inspection on 02/10/06 for Homecrest Residential Home

This inspection was carried out on 2nd October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Homecrest Residential Home 12/02/07

Homecrest Residential Home 17/02/06

Homecrest Residential Home 15/11/05

Homecrest Residential Home 14/09/04

Homecrest Residential Home 28/04/04

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

CARE HOMES FOR OLDER PEOPLE Homecrest Residential Home 49/55 Falkland Road Wallasey Wirral CH44 8EW Lead Inspector Les Smith Unannounced Inspection 2nd October 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 Homecrest Residential Home DS0000033293.V306731.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. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homecrest Residential Home Address 49/55 Falkland Road Wallasey Wirral CH44 8EW 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) 0151 639 7513 Norens LTD Linda Margaret Knapman Care Home 34 Category(ies) of Dementia - over 65 years of age (34) registration, with number of places Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Thirty Four (34) adults over the age of 65 (DE/E) with dementia and may from time to time admit persons between the age of 60 and 65 years of age. 17th February 2006 Date of last inspection Brief Description of the Service: Home crest is a detached three storey building in a residential area of Wallasey. There is off-street parking at the front of the building and a patio/garden area at the rear. Homecrest is close to local shops, amenities and public transport facilities. Home crest is registered to provide care for up to 34 people Dementia over the age of 65 and may accommodate younger adults between the age of 60 and 65 from time to time. All communal facilities are on the ground floor and a lift serves all storeys. Homecrest is an accredited holder of the British standards Institute ISO 9001and is also accredited for the ‘Investors in people’ award. Fees at Homecrest are within the range £300 to £399 per week. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on 2nd October and 6th October 2006 and lasted for a total of 9 hours. During the visit time was spent examining records, policies and procedures and a tour of the home was undertaken. Discussions took place with residents, relatives, members of staff, and the registered manager. Relatives spoken to were unanimous in their praise for the home, the care provided and all made comments to support their view, ‘the care is very good and there is a lovely homely atmosphere’, ‘excellent all round, the home is always busy’, ‘staff do all in their power and the home has improved a great deal’ and ‘there is always something going on, there is a good range of activities’. Members of staff were observed to be going about their work in a cheerful manner and clearly had good relationships with the residents. The home had completed a pre-visit Annual Quality Assurance Assessment and questionnaires were distributed to relatives and GPs prior to the visit. A summary of the responses is detailed below. Responses to questionnaires sent to a random selection of relatives / representatives of residents Yes 1 2 3 4 5 6 7 8 9 10 Do staff welcome you in the home at any time Can you visit your relative/friend in private Are you kept informed of important matters affecting your relative/friend If your relative /friend is not able to make decisions, are you consulted about their care In your opinion are there always sufficient members of staff on duty Are you aware of the homes complaints procedure Have you ever had to make a complaint Are you made aware of forthcoming inspections Do you have access to a copy of the inspection reports on the home Are you satisfied with the overall care provided 5 5 5 5 4 3 2 0 2 5 No 0 0 0 0 1 2 3 5 3 0 Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 6 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. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 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 Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 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): 1,2,3,4,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Prospective residents or their representatives have sufficient information to make an informed decision on were they wish to live but cannot be cofident that their needs will be fully assessed or that those assessed needs can be met. EVIDENCE: The Statement of Purpose and Service User Guide require updating to fully meet requirements. Following revision it is recommended that the Service User Guide be distributed to all residents or their representatives. The existing Statement of Purpose and Service User Guide are well presented and readily available to residents and their families. Each service user has a contract detailing the terms and conditions and these were evidenced on the residents files examined. Residents are only admitted to Homecrest following a detailed pre-admission assessment. The pre-admission assessment includes comprehensive information in relation to mental health and behavioural patterns. All preHomecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 9 admission assessments are carried out by the homes manager or deputy and include direct input from the prospective residents family or representative and other health care professionals involved. The actual written assessments are not always completed in full with some information being entered directly into the relevant care file documents. Pre-admission documentation must be completed in full to provide an audit trail for possible future reference. Care files examined also contained copies of the assessments from social services and other health care professionals involved. The home is fully equipped with appropriate aids such as handrails and assisted bathrooms. A well-motivated and stable workforce provides care but is compromised by a lack of specialised training in relation to dementia, challenging behaviour and protection of the vulnerable adult. It is essential that staff receive appropriate training relevant to the work they are to carry out. The manager encourages and promotes visits or trial periods of stay in the home before the resident moves in on a permanent basis. Discussions with the manager at these visits and the written information provided allow prospective residents’ and their representative to make a fully informed decision. Homecrest does not provide intermediate care. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a comprehensive and consistent care planning process in place that supports residents by providing staff with the information they need to meet identified and changing needs. Medication management needs improvement to fully comply with good practice guidelines. EVIDENCE: A selection of care files and related documentation was examined this visit. Care plans included biographical, physical and mental health details and risk assessments. Risk assessments for pressure sores e.g. Waterlow score, Nutrition, falls risk, mobility and handling were in place and up to date for all residents. Care plans detailed specific interventions for mental health as well as physical problems and also detailed behavioural triggers and specific interventions. Care plans were reviewed on a regular basis and demonstrated that changing needs were reported. However the care plans are not always updated to reflect the changes detailed in the reviews. It is essential that care plans are up to date and show the current care needs and associated interventions. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 11 A separate record within the care plan recorded all visits by health care professionals and records were seen detailing visits by GPs, district nurses, continence specialists etc. There are no residents self-medicating at Homecrest. The MAR sheets were examined and all were completed with no signature gaps. Residents drugs returned to pharmacy are recorded, a date and signature from the pharmacy representative being obtained when returned. Records indicated that on one occasion two tablets of Co-Codamol had been given but not signed for and a liquid preparation of Trazadone showed a shortfall of 30 – 40mls. Handwritten entries on the MAR sheets were seen with only one signature and in one case no signature. Out of date creams were seen to be in use. Temperatures for the fridge were not always recorded and the refrigerator itself was not secure and in need of a thorough internal clean. Staff members were observed interacting with residents and always spoke courteously, addressing residents respectfully at all times and delivering care with dignity. Shared rooms are provided with screens to allow personal care to be given in a discrete and sensitive way. The home has appropriate policies and procedures including guidance on cultural preferences in relation to dying and death. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. As far as possible residents have choice and flexibility in how they spend their day in the home, and pursue leisure activities according to their choice and preferences thereby allowing independence and individuality for each resident. Meals at Homecrest are good, offering choice and variety whilst catering for residents dietary needs or cultural preferences EVIDENCE: Key workers in conjunction with residents and their families develop a life story for each resident and record personal likes and dislikes and in the care files. Daily routines are as far as possible arranged to meet individual preferences. The home’s activities co-ordinator is scheduled to attend an appropriate course and currently provides a range of activities on both a group and one to one basis using a resource pack from Age Concern. Each resident has their own individual activities programme and care staff are encouraged to participate in all aspects. It is strongly recommended that participation in activities be recorded in the care files. This would help to develop a profile of likes and dislikes of individual residents. There is an accepted need for ongoing development of social and recreational activities based upon individual life experiences and capabilities particularly for those residents who have limited Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 13 communication or sensory impairment. Staff members continue to hold events such as a summer fair to raise funds to purchase additional leisure materials for the residents. All religious denominations are served by a catholic service being held in the home every Friday and there are regular interdenominational services. Outside entertainers visit the home regularly. Staff members were seen to be interacting on a social level with residents during the course of this visit. Family members and friends and other visitors are welcomed at the home at any time and visitors were seen in the home from early morning and throughout the day. A varied and healthy diet is provided with residents special dietary needs or cultural preferences being catered for. During this visit meals were observed being served and the meal was clearly enjoyed by the residents. Staff members were observed helping residents in a discrete, unhurried and sensitive way during the mealtime. The menus seen were varied and provided for alternatives for each meal. The kitchen was clean and well organised. Fridge and freezer temperatures were recorded as required. The food stores were examined and found to be clean, well stocked and well maintained. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. There are policies and procedures in place for the management of complaints and protection from abuse but non-compliance and a lack of relevant training does not promote confidence in effective management of complaints or protection from abuse. EVIDENCE: The CSCI has received no complaints since the last visit and there is no record of any complaints made directly to the home. However, details of a complaint from a current resident was seen dated 4th August which had not been documented or actioned. It is strongly recommended that a complaints register be established and that all complaints whether verbal or in writing are recorded together with details of the complaint and the actions taken are documented in order to demonstrate an open and transparent process and promote confidence that all complaints will be taken seriously. All residents are registered on the electoral roll and have the opportunity to exercise their legal rights. Policies and procedures to be implemented in the event of abuse being suspected are held within the home and the registered manager is responsible for ensuring compliance. Training has started but the records show that currently only 7 out of 18 care staff and none of the 10 ancillary staff have received training in recognition of abuse, its various forms and the procedures to follow if abuse is seen or suspected. It was a requirement at the previous visit that all staff members receive training in protection of the vulnerable Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 15 adult by 31st March 2006 and the commission will now take appropriate action to ensure compliance. The home has a whistle blowing policy and all staff members are made aware of their responsibility to ensure the protection of service users. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of environment at Homecrest continues to improve and ongoing investment will promote a safe and comfortable place to live for the residents. EVIDENCE: Ramps and handrails facilitate access to both the homes front entrance and the rear garden. Rooms are spacious and airy and decorated to a good standard. A tour of the home showed that: Lounge 1 has been redecorated and refurbished Lounge 2 needs decorating and refurbishment Vanity units in 5 rooms were in poor condition and need replacement Rooms 19 and 20 have been redecorated The window on the first floor landing has no opening restrictor in place The back of wardrobe in room 6 has come away from frame Four rooms had stocks of pads stored on open view Room 12 was malodorous and being considered for alternative flooring Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 17 Flammable materials were stored under the stairs Pads were stored inappropriately in the sluice New flooring required in toilet 1 – outstanding requirement from last visit New flooring and refurbishment required in bathroom – outstanding requirement from last visit New flooring required in dining room – outstanding requirement from last visit The manager stated that the outstanding requirements are scheduled for completion within the next month and that the delay was due to the major refurbishment of the lift, which has now been completed. It is strongly recommended that during redecoration consideration be given to provision of a more enabling environment using appropriate ways such as colour coding e.g. bathroom doors painted a different colour together with relevant pictorial and tactile wall decoration and signage. It is important for residents’ wellbeing that existing capabilities are maximised at all times and in all aspects of daily living. There are sufficient bathrooms and toilets available and two of the single rooms have ensuite facilities. Handrails are fitted throughout the home in all appropriate areas and a passenger lift serves all floors. Specialist equipment such as wheelchairs and pressure relieving mattresses are provided as necessary. it was evident that residents are encouraged to personalise their rooms with their own memorabilia and personal possessions. The front of the home is a parked area but is inaccessible to residents. There is a large well-maintained garden to the rear of the home. On the day of inspection the home was clean, pleasant and hygienic with no odours present other than room 12 as previously mentioned. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff members are recruited via robust policies and procedures, and are deployed in sufficient numbers and skill mix but have not received the training appropriate for the work they carry out which limits the support available to residents. EVIDENCE: Homecrest has a staff complement that is an appropriate skill mix and number to meet the needs of residents within the registered category. The gradual and inevitable deterioration of some residents leads to higher levels of dependency. Such changes in dependency may be addressed by requesting reassessment of needs by social services but where this is not the case the home is reminded that staffing levels must be kept under review and adjusted accordingly to meet increased needs. The home currently has 40 of staff members qualified to NVQ standard and this will increase to 50 in October 2006 when other staff members receive confirmation of their success in obtaining the qualification. There are a further four members of staff commencing NVQ 2 and one commencing NVQ 3. The home follows a robust recruitment procedure for all staff. Prospective staff is required to complete an application form prior to interview. Two references are taken together with Pova First clearance and enhanced Criminal Record Bureau checks being obtained. Staff files examined held all the required documentation. The home is reminded that reference requests should always Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 19 include the last employer and that any gaps in employment history should be explored with the applicant. The home has a staff training policy with requirements for the relevant mandatory training and other training as required enabling staff to carry out their duties proficiently. Training records examined show that mandatory training is up to date with the majority of staff due to renew their fire and manual handling in November and December. All members of kitchen staff have valid food hygiene certificates but only one carer has received this training. All members of staff that handle food should receive this training. Eight members of staff have received first aid training including six care staff. Five of the care staff first aid qualifications expired in October 2006 and must be renewed. The home is reminded that there is an expectation that a qualified first aider will be on duty at the home at all times including the night time periods. There has been no training in understanding and practice of measures to prevent spread of infection and communicable diseases. There has been no training in dementia care, non-violent intervention or challenging behaviour. Protection of the vulnerable adult training is addressed in an earlier section of this report. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Homecrest has effective leadership and guidance through an open and transparent management thereby promoting the health, safety and welfare of residents. EVIDENCE: The registered manager has substantial experience, holds the NVQ 4 and registered managers award and has been registered by the CSCI as a fit person to manage the home. Homecrest was awarded ‘Investor in People’ status in March 2004 and is also accredited by the British Standards Institute (BSI) and holds ISO 9001 certification. The BSI conducts six monthly quality assurance inspections. Residents or their representatives are consulted about the service offered on a yearly basis by way of a questionnaire, which is distributed and processed by Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 21 the providers’ head office every December. Staff meetings are held on a regular basis. Staff at the home receives formal supervision at regular intervals and appraisal on a yearly basis. Monies held for residents were checked against records and found to be correct. Receipts for expenditure were seen and are kept securely. No monies are held in a bank account. Fire alarm and emergency lighting checks are appropriately done and recorded. There have been no fire drills at the home since March 2006 and the home is required to carry out appropriate drills at least twice a year for day staff and four times a year for night staff and document the names of all staff present at the time of such drills. Coshh assessments have been undertaken and available in the appropriate areas and cleaning materials were seen to be stored securely. On the day of this visit the home was displaying a valid public liability certificate. Valid safety certificates were seen for lift including six monthly Loler certificates, Gas, Periodic electrical safety, fire alarm, Fire extinguishers, Fire risk assessment, Portable Electrical appliances, Hoists and assisted baths. Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 2 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 2 2 3 3 3 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 2 2 Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP1 Regulation 6 Requirement Timescale for action 31/12/06 2 OP3 14(1) 3 OP4 12(1) The registered person shall(a) keep under review and, where appropriate, revise the Statement of Purpose and the Service User’s Guide; and (b) notify the Commission and service users of any such revision within 28 days The registered person must 30/11/06 ensure that new service users are admitted only on the basis of a full assessment undertaken by people trained to do so and to which the prospective service user or their representative and any relevant professionals have been party and that such assessments . 30/11/06 The registered person shall ensure that the care home is conducted so as – (a) to promote and make proper provision for the health and welfare of service users; (b) to make proper provision for the care and, where appropriate, DS0000033293.V306731.R01.S.doc Version 5.2 Homecrest Residential Home Page 24 treatment, education and supervision of service users. 4 OP9 13(2) The registered person must ensure that medication management is in accordance with the Medicines Act 1968 and The Royal Pharmaceutical Society of Great Britain guidelines for medication management in Care Homes. The registered person shall ensure that any complaint made under the complaints procedure is fully investigated. The registered person shall maintain in the care home the records specified in schedule 4 – specifically Sch4(11) A record of all complaints made by service users or representatives or relatives of service users or by persons working at the care home about the operation of the care home, and the action taken by the registered person in respect of any such complaint 30/11/06 5 OP16 22(3) 31/10/06 6 OP16 17(2) Sch4 (11) 31/10/06 5 OP18 13(6) The registered person shall make 31/12/06 arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. Previous requirement dated 31/03/06 not met The registered person shall 30/11/06 having regard to the number and needs of the service users ensure that all parts of the home are kept clean and reasonably decorated. DS0000033293.V306731.R01.S.doc Version 5.2 Page 25 6 OP19 23(2)(d) Homecrest Residential Home 7 OP26 16(k) 8 OP27 18(1)(a) 9 OP30 18(1)(c)(i) 10 OP37 17(1)(a)(2) 11 OP38 23(4)(e) The registered person shall having regard to the size of the care home and the number and needs of the service users – keep the home free from offensive odours. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of the service users – (a) ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of the service users – (c)(i) ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform. (Refer specifically to training in relation to dementia and challenging behaviour) The registered person shall – maintain in respect of each service user a record which includes the information, documents and other records specified in Schedules and schedule 4 of the care Home Regulations 2001 The registered person shall ensure that by means of fire drills and practices at suitable intervals, that the persons working at the care home and so far as practicable, service users are aware of the procedure to be followed in case of fire, including the procedure for saving life DS0000033293.V306731.R01.S.doc 30/11/06 31/10/06 31/12/06 30/11/06 30/11/06 Homecrest Residential Home Version 5.2 Page 26 12 OP38 13(4)(c) 13 OP38 13(3) 14 OP38 37(1) The registered person shall 31/10/06 ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated and shall make suitable arrangements for the training of staff in first aid The registered person shall make 31/12/06 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home (refer specifically to training in infection control. The registered person shall give 31/10/06 notice to the Commission without delay of the occurrence of any death, illness or other event as specified in paragraph 1 items (a) to (g) of regulation 37 Care Home Regulations 2001 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 Homecrest Residential Home DS0000033293.V306731.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. 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