Inspection on 27/10/05 for Hopton Court

This inspection was carried out on 27th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Hopton Court 08/05/07

Hopton Court 15/08/06

Hopton Court 01/06/05

Hopton Court 07/12/04

Hopton Court 27/04/04

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

CARE HOMES FOR OLDER PEOPLE Hopton Court Hopton Mews Armley LEEDS LS12 3HT Lead Inspector Sue Dunn Announced 27 October 2005 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. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hopton Court Address Hopton Mews Armley LEEDS LS12 3HT 0113 263 2488 0113 263 2509 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) Southern Cross Care Management Limited Mrs Elaine Parker Care Home 40 Category(ies) of Dementia - over 65 (40) registration, with number of places Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 01 June 2005 Brief Description of the Service: Hopton Court is a 40 bedded home which provides care for people with dementia. The building meets current requirements for communal space and room sizes. All rooms are single with en suite wc and washbasin. Each of the two floors operates as a separate unit with a small secure garden area off the two ground floor lounges. Access between floors is via passenger lift. The home is situated in the Armley area of Leeds in close proximity to shops and other local amenities. There is off road parking and bus routes into the city centre are within walking distance. Digital locks on some internal doors and the main entrance provide additional security for people who wander. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection, which was announced, was undertaken by one inspector. The inspection started at 10.30am and finished at 5.20pm. The purpose of the inspection was to ensure the home was operating and being managed for the benefit and well being of the residents. A pre inspection questionnaire and comment cards were sent to the home before the inspection. Seven comment cards completed by relatives had been returned at the time of writing. The home has had two additional visits since the last inspection to investigate a complaint about the care. Requirements and recommendations made as an outcome of the investigation are included at the end of this report. The manager and organisation acknowledged that work was required to deal with the findings of the complaint investigation and a significant amount of progress had been made at the time of this inspection. Twelve of the requirements listed have been met within the timescales given and work is ongoing to improve standards further. What the service does well: What has improved since the last inspection? The organisation is in the process of reviewing the Statement of Purpose to make it more relevant to the home. Staff have received training from the operations manager on care planning and recording. The care plans contained more background information to help staff understand and be able to communicate more effectively with residents and give guidance on personal preferences. There was evidence to show the Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 6 involvement of other health professionals. Training has been given to understand the terminology of the risk assessment forms and staff were working on a care plan format to give guidance on how an identified risk might, where possible, be reduced. Training has improved with staff training records providing a means of checking each persons training. 80 of staff were enrolled on NVQ and the manager is working towards the managers award. The deputy manager has had some training on dementia and working with vulnerable adults. The home organised an outing to give people the opportunity to get out of the home. This was said to be successful and is to be followed by more trips out. The programme of staff training has included understanding adult abuse. Staff who had done the training had found it interesting and informative. The organisation has a psychiatrist who has advised on ways in which the environment might be improved for the benefit of the residents. The manager is currently introducing some of his suggestions into the home to help people to differentiate between different areas in the home and recognise the toilets and their own rooms more easily. The manager is less isolated, having good support from the operations manager and the company’s other specialist home in the area. Work has been done or is ongoing to deal with the following standards and requirements found at the end of this report. Standards 1,4,7,8,27,30 and 31. What they could do better: The home must make sure that assessments from other agencies are in sufficient detail to describe what needs have been identified. The purpose of the home’s own assessment is to show how the home can provide for each persons different social, recreational, emotional and spiritual needs as well as their personal care needs. The written content of the assessments done by the home did not provide enough information for an initial plan of care to prepare for each admission. Care plan recording had improved but still needs more work to show what has been agreed with each resident and if necessary their family. Staff should avoid slipping back into using generalisations such as ‘good sleep pattern’ or ‘good diet’ to describe care as this means different things to different people. Judgements made by the staff when evaluating the progress of care plans must relate to the source of the evidence in the daily records. There was a lack of imagination in the variety and presentation of the food on the day of the inspection. Items of protective clothing should be made available at the point where personal care is carried out in the interests of time management and dignity and privacy for residents. More should be done with the use of signs, land marks and a dedicated member of staff to help new residents settle into the home. The staff selection process and records should be more detailed in order to provide evidence of judgements based on offering equality if opportunity Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 7 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. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4,5 The quality of the assessment of need from other agencies did not give sufficient information to enable the home to know if needs could be met. In two files inspected the home had not carried out an assessment before admission with information to show how needs could be met and avoid inappropriate admissions. People have the opportunity to visit the home to assess it’s suitability. EVIDENCE: The Statement of Purpose and Service User Guide for the home has been reviewed and is being re written by the organisation therefore was not available for inspection. The Operations manager is aware that this will need to be discussed with the manager and staff and approved by the CSCI to ensure the document describes the services and facilities provided. A pre admission referral assessment for a recently admitted resident carried out by another agency was very limited and gave the home no information to show that the person’s needs had been identified. It is not acceptable for an assessment to simply state that ‘EMI’ care is required. The manager said that the home had recently admitted a resident whose needs they could not meet Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 10 as important information was missing from the assessment. This led to the existing residents being at risk and a second distressing move for the person concerned. The manager must be more proactive in asking for the information required to provide care before agreeing to admit anyone to the home. A senior care worker had completed a further assessment on the day another resident was admitted to establish the level of mental ability. This was an improvement on the previous assessments but should have been done before admission to the home and included comments which provided a plan of care to settle the person on the day of their admission to the home. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 Staff have benefited from training and there has been an improvement in the quality of recorded information relevant to each person’s care. It is acknowledged that there is scope for more improvement as staff learn to question practices and become familiar with new systems. EVIDENCE: The operations manager has given staff training on the use of care plans. The content of the care plans has improved since the last visit and those inspected contained more detail to show how each resident was being cared for and the background information. One file showed evidence of a planning meeting with the district nurse to agree a programme of care for pressure areas. Another gave detailed information for staff about the resident’s preferences at bedtime. However as every area assessed generates a separate care plan sheet there was a large volume of documentation and repetition. For example, two care plans covered smoking as one referred to breathing and the other to fire risks associated with smoking. Neither gave guidance on the daily number of cigarettes or times, as agreed with the resident. There was some indication that staff were slipping back into generalisations such as ‘good sleep pattern’ and ‘no fears for the future’ rather than giving more specific information about Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 12 individual preferences. Some of this may be dictated by the headings on the care plan forms. Staff have received training to understand the risk assessments being used and have developed a care plan format for the reduction of risks. For example one person has hourly night checks as a result of the monthly accident audit. A risk management plan is simply a care plan to show how a risk might be reduced. Staff feared this as more complicated than it needed to be. Daily records must make reference to the progress of care plans to provide evidence for the care plan reviews. This was not apparent in the files seen. Arrangements have been made with the pharmacist to provide medication training for the staff. The operations manager carried out a full medication audit in August and was satisfied that the medication was being handled appropriately. Medication checks are carried out as part of the system of monthly reports. Visitors/relatives felt the staff were patient and caring. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,15 Residents are supported to maintain contact with family and friends and visitors are welcomed at the home. There has been some progress made in trying to recognise needs other than health and personal care. There is room for improvement in the variety and presentation of meals in the home to ensure these are suitable for the age group and nutritious and appetising in content. EVIDENCE: The home has started to ask residents and their families for more information about each person’s background and interests with the aim of identifying social, cultural, religious and recreational needs. The manager stated that all staff have been made aware that residents can choose the times they get up and go to bed. Staff spoken with were aware of peoples’ routines but here should be more information about personal preferences in the personal care plans. Efforts have been made to take people out, with a trip to Lotherton Hall in September and a mini bus booked for another unspecified destination in the near future. A summer fayre attracted visitors from the community and children from the local primary school visited the home as part of their Harvest Festival celebrations. Visitors said they feel welcome when they visit. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 14 The afternoon tea was observed in one of the dining rooms. This offered a choice of chicken nuggets and chips or sandwiches followed by jelly and did not seem appropriate for adults. There were no table cloths, there was a lack of condiments or drinks on the table and the meal looked dry and unappetising. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 The home has a complaints and adult protection procedure for the protection of service users. Staff have started to receive training which gives them the knowledge and skills needed to ensure the procedures are understood and correctly followed. EVIDENCE: The manager had a good understanding of the role of the adult protection unit and her responsibility to report any allegations of abuse. Five staff have had adult protection training since the last visit and four more, including the manager, are booked on the next course. A care worker had found the course very informative and felt she had a much better understanding of some of the more subtle types of abuse. Two additional visits have been made to the home since the last inspection to investigate a complaint related to events during 2004 and the early weeks of 2005. The complainant raised concerns about the following:frequent falls, staffing levels, poor care practices and attitude of some staff, care planning and lack of family involvement in reviews, quality of reviews, poor communication within the staff team, disregard for residents dignity. The complaint investigation found all aspects of the complaint were either partially or fully upheld and concluded that the manager and staff had not received the training required to carry out their duties effectively. The organisation has made progress in meeting the requirements and recommendations from the complaint which are included at the back of this report. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 16 A member of staff who had completed the TOPPS induction training was able to show an understanding of residents’ rights to confidentiality of information. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 17 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) 19,20,21,22,23,24,25,26 The home was clean odour free and well maintained. Some work is being done to make the environment more suited to the needs of people with dementia. Some recommendations have been made. EVIDENCE: The company continues to invest money in effective odour control products. This, and the commitment of the manager and staff team, ensures that the home is clean and free from any offensive odours. One relative who had made a complaint about bed linen was pleased to report her concerns had been listened to and matters had improved. Four staff had been booked to attend infection control training the week after the inspection. The home is well equipped with protective gloves, clothing and products to reduce the risk of cross infection. These are stored in a locked cupboard some distance from the areas where they are required. It is recommended that in the interests of dignity for residents, time management and infection control that there are suitable storage arrangements for these products to be readily available in each of the toilet cubicles. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 18 There is a selection of specialist equipment some provided by the home and some on loan from the district nursing service in response to each person’s needs. Redecorating work has started, with some doors repainted in various colours so that residents can identify different areas of the home more easily. More could be done to provide ‘signing’ and distinct landmarks around the home for the benefit of new and existing residents to reduce the anxiety experienced by being in an unfamiliar place. Communal lounges provide a warm ‘homely‘ atmosphere and residents can use their own bedrooms at any time. Unfortunately as everyone else can also access the bedrooms this was said to lead to personal items of clothing going missing or being worn by other residents. Staff should be vigilant to ensure residents’ privacy and dignity is not compromised in this way. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The recent emphasis on staff training has improved the skill mix within the staff team and given them the knowledge to re examine their practices for the benefit of service users. Visitors and relatives praised the care and patience of staff. The recruitment procedures to protect service users had improved but the selection process and records should be more robust in the interests of equal opportunities and for the protection of the residents’ interests. EVIDENCE: The organisation has taken note of the previously low level of staff training and taken action to introduce a training programme to deal with the shortfalls. 80 of care staff had been enrolled on the NVQ programme and individual training records now make it easy to track what and when each person has done training. The records showed a formal 1week induction for new staff, and a rolling programme of adult protection, infection control, in house training on understanding assessments and care plans and some dementia training. Some areas such as fire training covered in induction had not been confirmed as there was no signature to show the employee had received and understood the information. Staff who were spoken with were enthusiastic and able to give some examples of their learning. Senior care staff were willing to discuss ways in which they could continue to improve the quality of care planning. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 20 The manager and inspector discussed ways in which all staff could be encouraged to put their training into practise for the benefit of the residents. Information from visitors and the comment cards was very positive about the attitude and approach of the staff and the care they gave to residents. The home has a recruitment and selection procedure. There had been some progress made towards improving the selection process to make it more robust. CRB checks and references are obtained before appointment. Inspection of the documentation showed two interviewers and relevant comments about the candidate’s responses on the interview assessment form. However only one interviewer had completed a comment sheet, there was no copy of the interview questions used and no employee specification upon which to base a judgement. One application form had not been fully completed to provide a full past employment history. The recruitment and selection records would not stand scrutiny under the terms of equality of opportunity in an employment tribunal. This has been discussed at previous inspections. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,36,38 The management of the home is reasonably well organised and staff are able to contribute to the decision making process. . The interests of the residents are seen as very important to the manager and staff. Systems are in place for the safeguarded of residents and staff. EVIDENCE: The manager has good experience of working with people with dementia but has not had the opportunity until now to develop her management knowledge and skills. She should have had the NVQ4 Managers Award or equivalent by April 2005 and a recognised qualification in dementia care to meet the standards. The new organisation in control of the home has noted the shortfalls and provided support for her to undertake the Managers Award, which she has almost completed. Further training is planned to enable her to meet the conditions of her registration. The manager has recently become aware that she must adopt a more proactive style of management if standards and consistency of care is to be maintained throughout the home. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 22 Several relatives of the manager are employed in the home and she careful to ensure other staff do not perceive this as a threat. A regular programme of staff supervision is now underway to allow staff to discuss any ideas or concerns about care on a one to one basis. The deputy manager has completed a short course on dementia and done the protection of vulnerable adults training. She is to start the Managers Award training when the manager has completed the course. The home has good support from the operations manager and is working closely with the company’s other specialist care home in the city. The organisation has a robust system of Health and Safety with regular meetings for managers and weekly bulletins which all staff are expected to read and sign. A maintenance person is employed in the home to carry out routine safety checks and deal with any day to day repairs. Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 23 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 2 x 2 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 3 x x x 3 x 3 Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 24 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 1 Regulation 4,6 Requirement The home must be clear about the level of care it can provide within its of registration and review the Statement of purpose to ensure staff can continue to meet the needs of all residents at any given time The home must not admit residents without first receiving a satisfactory assessment of needs from other professionals.The assessment of need must clearly show each person level of cognitive functioning and give sufficient background information to help staff understand the needs of the person behind the illness. Care plans must be written in consultation with the service user or their representative in a way which give gives clear guidance to staff as to how the service user’s health and welfare needs are to be met. Care plans must be kept under review by people with the skills to know what they are doing and amended in response to changing needs. Care reviews must be held at a time when Timescale for action 30.11.05 Under review 2. 3,4.2,4.4 14 31.12.05 3. 7.4 7.6,37.1 15.-1,18. 1C 14.2a and b, 31.12.05 Staff have had training Arrangeme nts for reviewing care plans have improved Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 25 4. 7.4 14.2a and b, 18.1c 5. 7.2, 8.3 13.4a,b,c, 142b,18.1c, 12,13 6. 17.1,18.1 13,17 7. 37.1 17,18 8. 8.3 12,13,18 9. 8.10,8.13 12 family or other representatives of a resident can be present. Review notes must be sufficiently detailed to show any discussions and any action which requires amendments to the care plan Care plans must be kept under review by people with the skills to know what they are doing and amended in response to changing needs There must be evidence to show that every fall has been examined and a risk management plan considered. Accident records and risk assessments must link in with the care plan.The home must be proactive in providing care in a way which reduces the risks of pressure sores developing. Staff must be given training to understand what they can do Decisions to use equipment which restricts movement must be recorded as part of the amended care plan and show the benefits of the action Day to day records must give information which describes the events in each residents life and the action of staff, or any other visitors or professionals, to provide continuity of care. The home must be proactive in providing care in a way which reduces risks of pressure sores developing. Staff must be given training to understand what can do The home must show evidence they do everything they can to make sure people receive proper medical attention 30.09.05 30.09.05 Care plan training started 30.09.05 Care plans reviewed 30.09.05 Daily records improved 30.09.05 30.09.05 Training started on Care plans and information recording Page 26 Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 10. 7.4,37.1 15 11. 27 18 12. 30.1 12,18 13. 31.1,31.2 9,10 Care reviews must be held at a time when family or other representatives of a resident can be present. Review notes must be sufficiently detailed to show any discussions and any action which requires amendments to the care plan Staffing arrangements and numbers must be reviewed and amended if residents physical care needs increase Staff must be given training which develops their communication skills and assists them to maintain good personal and professional relationships with service users and their representatives The manager must have an approved management qualification. The manager must work towards having a recognised qualification in the care of people with dementia The care staff working in the home must be given training appropriate to the work they are to perform50 of care staff must have the NVQ award in care and must be appropriately supervised. Staff must be given training which develops their communication skills and assists them to maintain good personal and professional relationships with service users and their representatives The home must not admit residents without first receiving a satisfactory assessment of needs from other professionals The home must provide suitable and nutritious food at all times 30.09.05 As required 31.03.05 14. 31.4 9,10 31.12.06 Working towards NVQ4 award 31.12.07 15. 27.1,30.1 12,18 31.12.06 Staff enrolledon NVQ. Communic ation improved 16. 3 14 31.12.05 17. 15 16 31.12.05 Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 4,7,8 Good Practice Recommendations The organisation should review the volume and type of paperwork used for care planning to make sure that it is relevant to the group care the home is caring for and being used to inform care. There should be a system of prioritization of each persons care plan so that goals are current and meet the main presenting needs of each resident The home should introduce a system for monitoring on a weekly basis any marks, rashes, bruises or any other changes observed in residents A selection of care plans and progress reports should be discussed at each staff supervision to make sure that information is not overlooked There should be a system for senior care staff to keep the manager informed of any changes or events during that shift and discuss any action required. 2. 3. 4. 5. 7,3,7 8 36 31 Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 28 Commission for Social Care Inspection Aire House Town Street Rodley LEEDS, LS13 1HP 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 Hopton Court 20051027 Hopton Court AN Stage 4 J52 V208998 S1467.doc Version 1.40 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!