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Inspection on 03/05/06 for Landmere Care Home

Also see our care home review for Landmere Care Home for more information

This inspection was carried out on 3rd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides care for people with complex physical and psychological needs, creating a therapeutic environment where peoples capacity to engage in daily life is assessed and opportunities made available to them to socialise and participate in their chosen interests.Some people are supported to engage in activities outside of the home while others needing special support have a structured daily life. Senior staff are qualified in mental health nursing and care staff receive training in the needs of the residents, which ensures that staff have the skills to look after the residents accommodated.

What has improved since the last inspection?

The management of complaints has improved and all complaints have been dealt with by the provider within the timescales.

What the care home could do better:

The registered person must ensure that staff undertake a full assessment of the residents needs and use all the information available to them from external professionals involved in the person`s care, this will inform a plan of care that can then be used as a yardstick for judging whether appropriate care is delivered to the resident. When care plans are evaluated this information must be used to write a revised care plan as conditions change. There could be better emphasis on maintaining the abilities of residents that become acutely physically ill to ensure that once the acute stages of illness are over the person is assisted to return to their normal level of functioning. The most important and easily lost skill is that of mobility, staff must provide better emphasis on maintaining mobility for the resident. More consultation is required when making decisions on care; the plans must be drawn up wherever possible with the resident or their representative and signed by them. There should be more emphasis on valuing the residents` dignity and their right to be supported in religious observance to meet their individual needs.Improved observance of safe infection control practices is required to as far as possible minimise the risks to other residents and staff. There should be appropriate referral to external specialists such as Dietician when risk assessment indicates this is needed. The resident should be assessed for the ability to maintain a safe body temperature and staff should be aware of what actions are necessary to maintain them at a safe temperature. Staff must be observant to and promote the dignity of residents who may not keep their clothes on. There needs to be a much better system for staff files that includes easily referenced checks on staff that are required both at the commencement of employment and periodically. The renewal of damaged armchairs is required to enable safe control of infection standards and to prevent injury to residents from ripped vinyl.

CARE HOMES FOR OLDER PEOPLE Landmere Care Home Ruddington Lane Wilford Nottingham NG11 7DD Lead Inspector Mary O`Loughlin Unannounced Inspection 3rd May 2006 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.V288460.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 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 9455940 0115 9827341 Lifestyle Care PLC Ms Yolanda Wasylko 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.V288460.R01.S.doc Version 5.1 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. 22nd November 2005 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 the registered provider is Lifestyle Care PLC. 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 are from £423.00 to £630.00 Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted over 6.5 hours and was unannounced. A range of information was used to inform this report. Four residents were case tracked which requires the inspector to look at the care plans for the resident and determine if the resident is receiving appropriate management of their condition and access to equipment and services according to their assessed needs. Management and staff were spoken with. Records were examined. Residents and relatives were spoken with. Information from the inspection reports from Environmental Health, Fire Services and Supplying pharmacists are incorporated into the report. Observation of the environment and practices. The Primary Care Team specialists and the Commissioning Team were also present at the time of this inspection and were undertaking their own inspection to ensure the management of the residents’ conditions was compliant with the National Minimum Standards. In general the residents were receiving care according to their assessed needs. What the service does well: The home provides care for people with complex physical and psychological needs, creating a therapeutic environment where peoples capacity to engage in daily life is assessed and opportunities made available to them to socialise and participate in their chosen interests. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 6 Some people are supported to engage in activities outside of the home while others needing special support have a structured daily life. Senior staff are qualified in mental health nursing and care staff receive training in the needs of the residents, which ensures that staff have the skills to look after the residents accommodated. What has improved since the last inspection? What they could do better: The registered person must ensure that staff undertake a full assessment of the residents needs and use all the information available to them from external professionals involved in the person’s care, this will inform a plan of care that can then be used as a yardstick for judging whether appropriate care is delivered to the resident. When care plans are evaluated this information must be used to write a revised care plan as conditions change. There could be better emphasis on maintaining the abilities of residents that become acutely physically ill to ensure that once the acute stages of illness are over the person is assisted to return to their normal level of functioning. The most important and easily lost skill is that of mobility, staff must provide better emphasis on maintaining mobility for the resident. More consultation is required when making decisions on care; the plans must be drawn up wherever possible with the resident or their representative and signed by them. There should be more emphasis on valuing the residents’ dignity and their right to be supported in religious observance to meet their individual needs. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 7 Improved observance of safe infection control practices is required to as far as possible minimise the risks to other residents and staff. There should be appropriate referral to external specialists such as Dietician when risk assessment indicates this is needed. The resident should be assessed for the ability to maintain a safe body temperature and staff should be aware of what actions are necessary to maintain them at a safe temperature. Staff must be observant to and promote the dignity of residents who may not keep their clothes on. There needs to be a much better system for staff files that includes easily referenced checks on staff that are required both at the commencement of employment and periodically. The renewal of damaged armchairs is required to enable safe control of infection standards and to prevent injury to residents from ripped vinyl. 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. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 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.V288460.R01.S.doc Version 5.1 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 the following standard(s): 3-6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The failure to ensure that all residents receive assessment and care planning on admission may not ensure that the home meets the person’s needs or promotes the health and welfare of the resident. Intermediate care is not provided at the home. EVIDENCE: The records of an emergency respite resident were examined. Pre admission assessment information was completed at time of admission which covers all standard 3.3. A Social services assesment was also on file. The manager audited the file within 72hrs to ensure all care plans and documents were completed appropriately, the document highlights the Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 10 ommissions in the documentation but no reference to who or when these would be completed. The resident was admitted for short term care. The care plan shows good practice in the management of an acute condition. However there was a lack of completed risk assessment that was required to ensure the person’s physical wellbeing and promotion of rehabilitation to ensure that the person’s physical abilities did not deteriorate and prevent appropriate discharge home. There was evidence that the resident was receiving care to prevent the development of pressure sores. The residents mobility plan had to be prompted by the relatives to ensure staff took appropriate action to re-mobilise the resident in good time to prevent any loss or deterioration in mobility. The inspection of August 2005 found that a resident having been at the home for 6 days had no care plan in place and subsequently a requirement was set. At the last inspection of the home in November 2005 the manager assured the inspector that compliance was achieved in meeting this requirement. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 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 the following standard(s): 7-8-9-10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The residents’ health, personal and social care needs are set out in a plan of care but the not all information is used to inform the plans, which may present a risk to the resident. Residents have their health care needs assessed and are supported to access appropriate external specialists if required. The management of medicines in the home safeguards the residents. The arrangements around care giving may not ensure the dignity of the residents. EVIDENCE: Records of three residents show that they are assessed in aspects of their health, personal and social care needs compliant with Standard 7.2 Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 12 However, the plans did not on one occasion indicate that the staff had considered the information received from external specialists for those on the Care Programme Approach as required Standard 7.6. The plans were reviewed monthly and audited by the regional manager. However minor changes in the resident’s condition were noted in the evaluation but were not informing the original care plan, which could misleading. The plans contained evidence of falls risk assessment, which is good practice. None of the plans seen contained evidence that either the resident or their relative had been involved in the drawing up of the plan which is required to ensure that they are in agreement with the plan and can understand the style that it is recorded in. One relative spoken with had not seen a care plan but was consulted on changes either as they happened or during visiting times. Personal hygiene plans were in place to ensure residents were appropriately supported. There was good assessment of and provision of equipment to support people who may be at risk of developing pressure sores. There was some discrepancy noted in the provision of a care plan to address the needs of a person with a high pressure sore risk, however the staff were managing the person appropriately and there was evidence of the correct equipment in use and the recording of positional changes. It would be good practice to ensure that all residents particularly those with acute medical conditions, have a mobility assessment and plan in place that ensures the person receives prompt and timely remobilisation to maintain their abilities. Each resident receives a continence assessment and access to any equipment required. The home provides care for people with Mental illness and Dementia; care plans seen indicated good assessment of the person’s behavioural problems and strategies to meet them. A recent event in the home has required that one wing be closed due to damage received when a resident had become disturbed and unmanageable. Staff are receiving training on managing difficult behaviours and qualified staff are trained in mental health. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 13 For one resident on the Care Programme Approach, the information required to safely acknowledge and manage the risks regarding their psychological wellbeing were not addressed in the home’s care plan. Nutritional screening is completed monthly and residents are weighed monthly. From the information contained within the supplying pharmacist’s report for January 2006 the home ensures that there is a policy on the management of medicines in the home and that the receipt, recording, storage, handling, administration and disposal of medicines are compliant with the requirements of the Medicines Act. The medicine record sheets for those residents case tracked on this occasion supported the findings. One record of a hand written prescription did not have a signature or a witness signature, which would be good practice. Residents are not assessed for their ability to self medicate. People are dressed in their own clothes and encouraged to continue relationships and receive visitors of their choice. In general the residents dignity was maintained with appropriate dressing and personal care. One resident who was unable to be cared for in bed due to the high risk of falling had been nursed on a mattress on the floor, this is a recognised practice to manage people’s safety, however there was no recorded evidence in the care plan to suggest what consultation process had taken place. There was no evidence to suggest that other strategies had been considered or if the Occupational Therapist had been requested to assess the person. One resident with MRSA was left with exposed wound areas whilst sitting in his room. No footwear had been worn and the resident had been left with his feet on the vinyl floor whilst waiting to have a change of wound dressings. The staff had not ensured the person’s dignity or maintained the person’s body temperature safely. Two relatives confirmed that they were very happy with the care provided. One resident confirmed that care provided was good and that staff were kind. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 14 Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 15 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 the service. Service users are enabled to find a lifestyle that suits their need; they may maintain contact with family and relevant others as desired and exercise choice and control over their lives where able. Service users receive a wholesome and appealing diet in pleasing surroundings. EVIDENCE: Evidence from the last inspection was used to inform the outcome of these standards. The home continues to provide appropriate and varied opportunities for residents to engage in activities and interests of their own choice. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 16 Excellent records are held of the involvement of residents in daily activities to suit their needs and capacities. There are opportunities for people to attend religious services but little recognition of the person’s beliefs and practices are recorded in the care plans seen. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 17 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): 16-18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents can be assured that their complaints will be listened to, taken seriously and acted upon. There are policies and procedures in place to protect the residents from Abuse. EVIDENCE: The last inspection of the home found that all appropriate policies and procedures were in place and recognised by the staff at the home to ensure the safety of the residents. Individual complaints are recorded appropriately and action taken in the timescale. One adult protection investigation has been undertaken by the Social Services and involving the Primary Care Team and Commission for Social Care Inspection. The Social Services have continued to monitor the service during this time and were present doing their own inspection on this day. The Owner has acted upon the findings of this investigation appropriately. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 18 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): 19-22-26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home provides a safe well maintained environment. The home has the equipment and adaptations necessary to meet the needs of the residents. Infection control practices may not protect the residents from infection. EVIDENCE: The home was found to be clean and warm. The grounds are well kept and a programme of maintenance is in place for the renewal of the fabric and decoration of the building. The home has an appropriate fire detection system in place and is compliant with local Fire and Environmental services. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 19 A report from an Occupational Therapist has been provided to the Inspector showing that the home is suitable for the categories of residents accommodated and that all necessary equipment and adaptations are in place to meet the needs of the residents. Furnishings were mostly of a good standard but some armchairs need replacing as they are torn and do not allow for cleaning and could injure residents as a result of ripped vinyl coverings. The laundry facilities are in compliance with Minimum Standards and the equipment is able to provide safe washing temperatures to control infection. Legionella controls are compliant. One room had a wardrobe door leaning against a wall and required urgent repair. Waste bins did not all have a lid, which is required to control infection. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 20 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 good. This judgement has been made using available evidence including a visit to the service. The staffing numbers and skill mix is suitable for the number and needs of the residents. Staff are trained and competent to do their jobs ensuring that residents are in safe hands at all times. Recruitment practices safeguard the residents from people who may be unsuitable to work with vulnerable adults. EVIDENCE: Staffing numbers and skill mix was compliant at the last inspection. The registered provider keeps the Commission informed of any changes in numbers and actions taken to manage the shortfalls. The present staffing levels are in excess of the minimum numbers due to the temporary closure of one wing at the home. The manager reported that at least 50 of the staff are trained to level 2 NVQ and records of certification were seen. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 21 The last inspection required the home to retain evidence of the qualified nurse registration numbers to ensure they were verified and remain up to date with their registration. This inspection examined staff files to determine compliance had been achieved. There was evidence of registration numbers being retained on file. There was also evidence of CRB and POVA checks being undertaken for all new staff. Some staff files had no evidence of CRB checks as the provider destroys these documents after 6months; the clearance number is to remain on file according to the manager. Evidence of CRB numbers or renewals was not examined at this inspection. The staff files require better management to ensure that there is a clear system for ensuring all the appropriate documentation is in place. Staff files contained evidence of appropriate induction and foundation training for staff. Staff training certificates were seen and staff confirmed receiving training. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 22 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): 31-33-35-38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is a registered manager in place who is competent and experienced, she is able to lead the staff team and ensure that the home is run in the best interests of the residents. The health, safety and welfare of the residents is protected by the home’s policies and practices. Residents financial interests are safeguarded. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 23 EVIDENCE: A suitably qualified person presently manages the home until the new manager commences work in July 2006. The previous acting manager remains at the home as deputy manager. The quality assurance system was compliant at the last inspection and discussion with the acting manager provided information that ensures the home are still carrying out their responsibilities to measure the home in meeting its aims and objectives and statement of purpose. Residents finances are appropriately managed and sample scrutiny of two residents personal financial records show that the residents are safeguarded by the accounting and financial procedures in place. There is a health and safety policy in place and staff receive training in health and safety. Evidence of mandatory training in Moving and Handling, Fire, Food Hygiene and First Aid was seen. The manager ensures the safe storage of chemicals with data sheets retained in the home. Water systems are safely maintained with records of the temperature checks, which safeguards the resident from hot water risks. Accidents and incidents are appropriately recorded with monthly audit that informs the care delivery and policy. Some staff files had no evidence of CRB checks as the provider destroys these documents after 6months; the clearance number is to remain on file according to the manager. Evidence of CRB numbers or renewals was not examined at this inspection. The staff files require better management to ensure that there is a clear system for ensuring all the appropriate documentation is in place. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 24 Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 25 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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 2 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 3 X 3 X 3 X 2 3 Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP3 Regulation 14 Requirement The registered person must ensure that all the required risk assessments and care plans are in place at the point of admission to ensure that the home are able to meet the person’s needs. Where there is an emergency admission this should be completed within 5 working days. The registered person must ensure that; 1. Care plans are drawn up with the resident and / or their representative and wherever possible agreed and signed by them. 2. Use information provided by the Care Programme Approach plan to inform the homes care plan. 3. Update the original care plan as conditions change. The registered person must ensure that residents receive a referral for Occupational Therapy assessment and that appropriate consultation takes place when there is a high falls risk that requires alternative methods of DS0000026450.V288460.R01.S.doc Timescale for action 30/06/06 2 OP7 15 30/06/06 3 OP7 13 30/06/06 Landmere Care Home Version 5.1 Page 27 4 OP8 13 management at night. The record of this consultation and any report from the specialist should be retained on file and not archived. The registered person must ensure that; 1. Residents mobility is assessed and strategies put in place to maintain their mobility. 2. Where the home’s nutritional assessment indicates the involvement of a dietician is required the care plan should reflect why the dietician is not involved. 3. The residents ability to maintain a safe body temperature should be assessed and strategies adopted to ensure they are safe. The registered person must ensure that residents are protected from the spread of infection. 1.Residents with MRSA must not be left without protective dressings on their wounds. 2. Staff must be trained and carry out the appropriate procedures to control infection. 3. Waste bins must be fitted with lids. The registered person must make suitable arrangements to maintain the dignity of the residents; Residents are assisted to dress appropriately and clothing is changed when they have spilt drinks on themselves. 30/06/06 5 OP8 13 30/06/06 6 OP10 12 (4)(a) 30/06/06 Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 28 That where footwear cannot be worn residents are not left with their bare feet on the cold vinyl floor. 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 2 3 4 5 Refer to Standard OP9 OP9 OP12 OP26 OP37 Good Practice Recommendations The registered person should ensure that residents are assessed as to their ability to self medicate. The registered person should ensure that where medicine administration instructions are hand written, that these are signed and witnessed appropriately. The registered person should ensure that each resident is given the opportunity to practice their religion and this should be recorded within the care plan. The registered person should ensure that torn vinyl furnishings such as chairs are replaced to maintain control of infection standards and prevent injury to the residents. The registered person should ensure that; 1. All staff files are put in order to provide a safe system of verifying that all documents are in place and accessible. 2. All CRB reference numbers are available for inspection 3. Confirmation that staff have received their terms and conditions of employment along with a copy of the General and Social Care Councils Code of Conduct. 4. Reference to date verification of the registration renewals of qualified staff. 5. Reference to the renewal date of CRB checks 6. Access the Pro-forma from the Commission regarding staff information, which should be kept on file. Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 29 Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 30 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Landmere Care Home DS0000026450.V288460.R01.S.doc Version 5.1 Page 31 - 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!