Inspection on 12/09/07 for Landmere Care Home

This inspection was carried out on 12th September 2007.

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

Landmere Care Home 23/08/08

Landmere Care Home 04/03/08

Landmere Care Home 13/03/07

Landmere Care Home 03/05/06

Landmere Care Home 22/11/05

Landmere Care Home 02/08/05

Landmere Care Home 08/03/05

Landmere Care Home 07/10/04

Landmere Care Home 25/03/04

Similar services:

Hunter`s Lodge

Lester Hall Apartments

Harvey House

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

CARE HOMES FOR OLDER PEOPLE Landmere Care Home Ruddington Lane Wilford Nottingham NG11 7DD Lead Inspector Michael Williams Unannounced Inspection 12th September 2007 10:00 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 Landmere Care Home DS0000026450.V351538.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. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Landmere Care Home Address Ruddington Lane Wilford Nottingham NG11 7DD 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) 0115 945 5940 0115 982 7341 manager.landmere@lifestylecare.co.uk www.schealthcare.co.uk Southern Cross (LSC) Ltd Vacant Care Home 70 Category(ies) of Past or present drug dependence over 65 years registration, with number of age (70), Dementia (10), Mental disorder, of places excluding learning disability or dementia (10), Mental Disorder, excluding learning disability or dementia - over 65 years of age (70) Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 10 or fewer service users who may be accommodated in categories MD and DE must be aged between 55 and 65 years. 13th March 2007 Date of last inspection Brief Description of the Service: Landmere Care Home is a purpose built home divided into four units with a total of 70 places. The home provides nursing care for people over 65yrs with Mental Disorder, Dementia, past or present drug dependence. Ten places can accommodate people from 55yrs with a mental Disorder or Dementia. The home was registered with the Commission in 2002 and has recently been taken over by a new provider called Southern Cross Healthcare. Due to recent changes in restrictions to ages within registration categories, the registration certificate is now incorrect following review and will be replaced by the CSCI. The provider remains responsible for reflecting the specific services available within the statement of purpose. The home is situated in a residential area of Wilford, south of and on a bus route to the city of Nottingham. West Bridgford is close by and provides shops, library and leisure facilities. The range of fees is from £423:00 to £660.00; this does not include hairdressing, chiropody and toiletries. This information together with last inspection report is available upon request. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspection undertaken by the Commission for Social Care Inspection is upon outcomes for service users, and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice, and focuses on aspects of service provision that require further development. This was an unannounced key inspection undertaken by one inspector. The main method of inspection used is called ‘case tracking’ which involves selecting two residents and tracking the care they receive through checking their records and discussion with them, and observations of the care received and asking staff about their needs. Two residents and two members of staff were spoken with as part of the inspection. Other residents who were not part of the case tracking were observed and also spoken with. Documents and medication policy and practice were examined as part of the inspection to gain evidence and form an opinion about the residents’ health and safety. A partial tour of the premises was undertaken which included communal areas, and a sample of bedrooms to ensure that the environment was pleasant, homely and safe. The annual quality assurance assessment, and a review of all other information about the home received by the Commission since the last inspection was taken into consideration in planning this inspection and helped in deciding what areas of care were looked at. What the service does well: What has improved since the last inspection? Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 6 A dementia unit has recently been opened on the ground floor providing stimulating colour, light, and touch environment for people living in the unit. Odour control within the home has improved. Cultural needs such as same gender staff for personal care, religious needs and preference in music are recorded in care plans. The timing of meals and seat arrangements has been reviewed to encourage and support service users to lead the lifestyle they choose. Service users are fully supported by staff during meal times. Staffing rotas have been reviewed to ensure that sufficient levels of staff are available at all times to meet the needs of people living in the home. Staff feel supported and are in receipt of regular supervision. Systems are in place to ensure that records are made available for inspection as required by regulation. What they could do better: To ensure that prospective service users have sufficient information to make an informed choice about moving into the home, documentation containing information about the previous manager should be updated with details of the acting manager. A record should be maintained, when a service user guide or welcome pack are given to service users. Where restrictive practices or equipment such as lap belts, bed rails and safety gates are being used, appropriate risk assessments and care plans should be in place, to maintain service users safety and prevent potential abuse. Where practicable consent to care plans and the use of any restrictive equipment or practices should be sought from service users or their representatives. To ensure that health needs are met records for monitoring weight, challenging, behaviour, and pressure sore prevention, should be maintained. Systems should be in place to ensure that service users receive regular health checks that includes dental and eye care. To promote independence and choice, procedures to assess service users capacity to self medicate should be in place. Activity programmes should be reviewed to provide a stimulating environment, and opportunities for support service users to participate in community life. Links with advocacy support service should be developed and maintained to provide support for service users without independent representation. To protect service users, all complaints referred to the provider should be investigated appropriately through the complaints procedures process. A review of the complaints procedure should be undertaken to ensure that clear information is available about how complaints are dealt with and resolved. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 7 To ensure that service users are protected, staff recruitment records should contain details of the date and the issue reference number of criminal record bureau checks. Notification should be made to the Commission when service users are admitted to hospital via Regulation 37 requirements to ensure accountability. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2,3, 5 and 6, Quality in this outcome area is adequate Individual needs are assessed, however information is not available about the acting manager, which may impact upon prospective service users ability to make an informed choice about moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Files examined contained pre admission assessments of service user needs and contracts of the terms and conditions of the placement. Staff spoken with demonstrated a good level of understanding of the individual needs of people living at the home. The statement of purpose contains information about the aims and objectives of the home, the staffing structure and the facilities offered. There is a service user guide available, which provides further information about life living at the home. Both the statement of purpose and the service user guide are available in audio and Braille. The documents contain information about the previous manager and will need to be updated with details of the acting manager. Trial Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 10 visits are offered, however, there was no copies of service user information pack in rooms viewed, service users and relatives spoken with said that they could not remember if they had received a copy of this document. Intermediate care is not provided by the home. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 Quality in this outcome area is poor Health records are not maintained effectively and some service users are subjected to restrictive practices without appropriate risk assessments; care plans and consent are not in place, which places service users health at risk and could be viewed as abusive practice. Medication policy and procedures protect service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans are developed from pre admission assessments and risk assessments. Files viewed contained a range of care plans for individual need including, moving and handling, pressure care, eating and drinking, maintaining health skin, sexuality and personal hygiene. Care plans provided detailed information about how staff provide support to service users. It was evident that consideration is given to cultural needs and preferences, for example where service users preferences for male or female staff to provide personal care. Records examined evidenced that professionals such as doctors, health nurse, podiatrist and speech therapist are involved in maintaining the health of people living in the home, however there was little information about Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 12 how dental and eye care are maintained. Care plans are regularly reviewed, however, there was no consent to care plans by service users or their representatives. Staff spoken with demonstrated a good level of understanding of the needs of service users. Relatives and service users spoken with said that they were happy with the care provided and felt that health needs are met. “The doctor is always informed if we feel unwell”. It was evident from documentation examined and during discussions with service users and staff that rights are respected and dignity is maintained. “Staff are very polite and treat us with respect”. Examination of documentation found that health records are not being effectively maintained, placing service users health at risk. The weight records of one service users case tracked stated that they were too unsteady on their feet to be weighed. No alternative procedures have been implemented to ensure that the service users weight is regularly monitored, as set out in the care plan and the home’s health policy and procedures. Observations made during the inspection included the use of lap belts to support some service users sitting in chairs; safety gates being used at service user room doors, and the use of bed rails on beds. There was no evidence that any alternative methods of maintaining service users safety have been explored or that appropriate care plans and risk assessments supported these practices. In addition, there was no evidence that consent had been sought before exercising this restrictive practice. Medication in the home is well managed, and policy and procedures are in place, there are no procedures to assess service users capacity to self medicate. Staff administering medication said that they had received training, this was evidenced in staff training records viewed. Medication administration records are well maintained with no gaps. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate Consideration is given to meeting expectations and preferred lifestyles, however, opportunities are limited for service users to maintain choice and control of their daily lives This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual interests, social and cultural needs are covered as part of the pre admission assessment. There is an established weekly activities programme that includes activities such as, art and craft hand therapy, hairdressing, and dominoes. Details of activities are placed on service users notice boards around the home. Staff spoken with said that service users are encouraged to participate in group and individual activities. The activities co-ordinator position is currently vacant, activities are organised by the activities assistant and care staff. During the visit some service users were observed participating in an art and craft session, listening to music and reminiscing with old photographs. The social activity records in files viewed showed little recent community activity offered to people living at the home. Some service users spoken with said that they visited out local shops and went to church. However, others said that they wanted more community activities. “I do not go out anywhere”. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 14 Individual religious and cultural needs are assessed, however, care plans do not provide specific details of how these assessed needs are supported. Special dietary requirements and preferences are recorded in individual files, and nutritional screening tools and nutritional care plans are in place. Staff spoken with said that mealtimes are flexible and service users can have meals in their rooms if they choose, this was confirmed with service users spoken with. Menus are nutritious and balanced, but do not provide much choice for service users. The acting manager said that the menus are currently being reviewed. Staff were observed offering support to service users who required assistance with meals, taking care to ensure that support was offered in an appropriate manner whilst maintaining the dignity of service users. Family contact is encouraged and supported, relatives spoken with said that that they can visit whenever convenient for their loved ones, and are always made to feel welcome by staff. Some people living at the home do not have relatives visiting, and there is no advocacy in place to offer independent support. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is poor Service users feel that their views are listened to and acted upon, however, complaints and safeguarding issues are not managed or recorded appropriately to ensure that service users are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose contains the complaints procedure with timescales for responses and action; a copy of the procedures is displayed in the foyer of the home. Relatives spoken with said that they were aware of the complaints procedure and would speak to the acting manager if they were unhappy about the care being provided. Service users spoken with said that they would speak to staff if they felt unhappy and were confident that the manager would deal with complaints appropriately. Staff spoken with were able to demonstrate an understanding of their responsibilities regarding safeguarding adults and the whistle blowing policy. Since the last inspection, the Commission has received, three complaints, these were referred to the provider for investigation. One complaint was satisfactorily resolved, but there were no records of two complaints that were referred to the provider for investigation and the CSCI has not been informed of the outcome as required. There have been nine complaints received at the home, seven have been satisfactorily resolved and two are currently being investigated. There have been no safeguarding adults referral made but the issues highlighted in the health and personal care section indicate that the Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 16 practice of restraint is regularly used without appropriate risk assessment, consultation and care planning and can therefore be viewed as abusive and must cease. The format for recording complaints did not provide clear details of how individual complaints are received and resolved. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 and 26, Quality in this outcome area is good The home is generally clean tidy and comfortable, providing a pleasant environment for service users to live in. Current risk management practices place restrictions on movement around the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is generally clean, tidy and free from unpleasant odours, providing a pleasant environment for service users to live in. Communal areas are spacious, with several private areas available for service users to entertain relatives and guests. Furniture is in good state of repair, however some carpets are worn and ready for replacement. The acting manager said that the provider has agreed for the carpets to be replaced. This was evidenced in the annual action plan. A dementia unit has recently been opened on the ground floor providing stimulating colour, light, and touch environment for people living in the unit. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 18 Bedrooms viewed were spacious, and pleasantly decorated, service users said that they liked their rooms, although, there was inconsistency in the personalisation of rooms viewed. Some communal areas in the home are accessed through keypad system that restricts the movement of service users around the home. The acting manager said that this issue has been discussed with consultants and plans to remove the keypad door lock release systems have been agreed with the provider. The kitchen was clean, tidy and hygienic, food was stored safely, and appropriate food safety procedures and records are in place to maintain the health and safety of service users. The laundry was sufficient for the needs of people living in the home. Gardens to the rear of the property were pleasant and well maintained. The home’s action plan has an ongoing decorating programme, and during the inspection painting was being undertaken in areas of the ground floor, there was no risk assessment in place for this practice and service users and visitors were observed within the vicinity. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28,29 and 30 Quality in this outcome area is poor Sufficient levels of trained and competent staff are available to meet the needs of service users at all times, however recruitment practices do not ensure service users are in safe hands at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been a high turnover of staff recently, which has led to increased use of agency staff, the acting manager said that new staff have been recently recruited, and are currently completing inductions before commencing work at the home. The rota showed that there are adequate levels of staff on each shift to meet the needs of people living in the home, relatives and service users spoken with felt that sufficient levels of staff are available to meet service users needs. Staff spoken with were able to demonstrate a good level of knowledge about the needs of service users and how to support them. Staff files viewed showed that training had been provided in moving and handling, infection control, food safety, first aid, health and safety, dementia care and adult protection. This was confirmed with staff spoken with. Staff feel supported by the management, there are regular staff meetings and supervision is provided on a regular basis. Staff are recruited from varied backgrounds, examination of recruitment records showed that appropriate criminal record bureau checks (CRB) Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 20 information is not in place, there were no details of the date or the reference number of criminal record bureau checks. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35, 37 and 38 Quality in this outcome area is poor Service users are consulted about how the home is run, maintenance and safety management safeguard service users. However, the management of risks assessments, records and reporting of incidents within the home place service users health at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the inspection, the acting manager had been in position for four weeks. The acting manager is an experienced care home manager with over sixteen years experience of working in social care. The acting manager said improvements have been made, but there are issues within the home that still need to be addressed. There has been a high turnover of staff since the Southern Cross group acquired the home; new staff Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 22 have recently been recruited with the skills and experience to meet the needs of people living in the home. Staff are supervised and reported that the management is open and supportive, service users and relatives said that the acting manager was approachable and believed that the home is run in the interest of service users. Regular visits by provider representatives are undertaken to assess the quality of care, the home uses the Southern Cross quality audits system to monitor the quality of service provision. Information from audits is fed back to service users through manager surgeries, and is used to develop annual business plan for the home. Financial records viewed evidenced that robust systems are in place to manage service users finances. Examination of fire safety, maintenance, and servicing documentation showed that health and safety records are being effectively maintained. Shortfalls in management included, records for monitoring service users health not being maintained, placing service users at risk. There were no appropriate risk assessments or consent in place for the use of lap belts, safety gates and bed rails are in place, which place service users at risk of potential abuse. Records are not being managed effectively and the format for recording complaints does not provide sufficient detail of how individual complaints are resolved. There was no record of notification to the Commission when a service user had been admitted to hospital. Where painting was being undertaken on the ground floor, there was no risk assessment was in place. Staff recruitment records viewed, only contained criminal record bureau (CRB) applications, there were no details of the date or the issue reference number of criminal record bureau checks, which placed service users at risk. Documents contain details of the previous manager and will need to be updated with details of the acting manager. Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 1 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 2 3 X X 3 X 3 STAFFING Standard No Score 27 3 28 1 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X 1 1 Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 24 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(a) Requirement To ensure that prospective service users have sufficient information to make an informed choice about moving into the home, documentation containing details of the previous manager should be updated with details of the acting manager. Where restrictive practices or equipment such as lap belts, bed rails and safety gates are being used, appropriate risk assessments and care plans must be in place, to maintain service users safety and prevent potential abuse. To prevent potential abuse where practicable consent to care plans and the use of any restrictive equipment or practices should be sought from service users or their representatives To ensure that health needs are met records for monitoring weight, challenging behaviour, and turning service users must be maintained with up to date DS0000026450.V351538.R01.S.doc Timescale for action 31/12/07 2. OP8 13(7) 31/12/07 3. OP8 15:1 31/12/07 4. OP8 12:1 (a) (b) 31/12/07 Landmere Care Home Version 5.2 Page 25 5. OP9 12:3 6. OP12 12(4)(b) 7. OP7 15(1)(2) (c) 8. OP16 22:3 9. OP29 19:1(b) 10. OP38 37 information To promote independence and choice, procedures to assess service users capacity to selfmedicate must be in place. The cultural needs of residents, such as where suitable space for prayers is located and how religious observances are supported must be recorded in individual care plans. Where practicable, care plans must be developed and reviewed in consultation with the resident and/or their relative. This is an outstanding requirement from the previous inspection on 13/03/07 and now subject to a Statutory Requirement Notice to achieve compliance. To protect service users complaints must be fully investigated in accordance with relevant policies and procedures within the home, and the complainant must be informed of the outcomes. To ensure that service users are protected appropriate records of the date and reference number of staff criminal record bureau checks should be made available for inspection. To protect and safeguard service users welfare, notification must be sent to the Commission when service users are admitted to hospital 31/12/07 31/12/07 31/12/07 31/12/07 30/11/07 30/11/07 Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 26 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 OP1 Good Practice Recommendations It is recommended that a record be kept of when a ‘welcome pack’ is given out to prospective residents or their representatives. This is an outstanding recommendation from the previous inspection on 13/03/07 Advocacy services should be sought to provide support for service users without independent representation. A review of systems to monitor the identified health needs of service users should be undertaken to ensure that health needs including dental and eye care are maintained. Consult service users about the activity programme reviewed to provide a stimulating environment and opportunities for service users to participate in community life. A review of the complaints procedure should be undertaken to ensure that clear details are available about how complaints are dealt with and resolved. Develop a risk assessment to manage maintenance work and ensure service users safety. 2. 3. OP3 OP8 4. OP12 5. 6. OP16 OP25 Landmere Care Home DS0000026450.V351538.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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