Inspection on 01/02/07 for Laurels EPH

This inspection was carried out on 1st February 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

Laurels EPH 27/01/09

Laurels EPH 11/12/07

Laurels EPH 04/07/07

Laurels EPH 17/11/05

Laurels EPH 26/05/05

Laurels EPH 06/01/05

Laurels EPH 17/08/04

Laurels EPH 26/02/04

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

CARE HOMES FOR OLDER PEOPLE Laurels EPH Ely Way Luton Bedfordshire LU4 9Q Lead Inspector Mr Ian Dunthorne Unannounced Inspection 10:00 1 February 2007 st 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 Laurels EPH DS0000033128.V308733.R02.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. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurels EPH Address Ely Way Luton Bedfordshire LU4 9Q 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) 01582 576877 01582 847244 Luton Borough Council Maria Watkins Care Home 35 Category(ies) of Dementia - over 65 years of age (35) registration, with number of places Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No of residents; 35 Gender: Male and female Categories: Older people with Dementia DE(E) Provision for one named male under the age of 65 years, for respite care only; this condition refers only to the service user named on the variation application and for no other. The conditions of registration will revert to those that had been approved prior to the date of this certificate, when the service user attains the age of 65 years, or no longer requires the service. 17th November 2005 Date of last inspection Brief Description of the Service: The Laurels was one of the 5 elderly persons home owned by the Luton Borough Council. It provided care for up to 35 older people with a diagnosis of a dementia type illness. All the places at The Laurels were admitted through Social Services. The accommodation at The Laurels was on two levels with the main communal areas on the ground floor. The upper floor could be accessed via stairs or a passenger lift. The home had an enclosed garden to the rear of the building and a parking area to the front. The laurels was situated in a residential area of Leagrave, a suburb of Luton, close to a range of amenities and public transport links. Information provided regarding the home’s range of fees stated that the weekly fee was £630. These fees did not include newspapers, hairdressers, personal telephone, toiletries or private chiropodist; these services would incur an additional charge. The home had six vacant beds which were being held as vacant, for prospective service users from two Luton Borough Council home closures which were imminent, to transfer into. The transfer being based upon the appropriate category of registration being suitable for those service users proposed. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over nine hours during the morning, afternoon and early evening and it was unannounced. Prior to the inspection time was taken to review the information gathered since the last inspection and plan this inspection visit. This report also includes feedback from relatives and visitors obtained from postal comment cards. The inspection included a tour of the communal areas and several bedrooms, inspection of certain records, discussion with staff and the manager, discussion with service users, their relatives, visitors and observation of the routines of the home. The method of inspection was to track the lives of several service users. This was done by speaking to them about the service they receive, observing their life in the home, talking to staff and relatives and reviewing their records. What the service does well: What has improved since the last inspection? The manager felt that the homes leisure activities, which were made available, had improved for service users. The home regularly reviewed the service user plans. More suitable flooring had been fitted on the ground floor, which made the area appear clean & pleasant. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provided sufficient information for prospective service users, however it sometimes failed to identify the fees payable, which did not allow all service users to be aware of the fee and what they may need to pay. The information also needed to be updated, to ensure service users received the correct details. EVIDENCE: The homes ‘Statement of Purpose’ was displayed with a copy of the last inspection report in the homes entrance area. However the ‘Statement of Purpose’ was out of date in some areas and required updating, to ensure it provided the correct information and it was not always in a suitable format for the service users. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 9 There was evidence that the service users whose lives were tracked had written contracts with the home in the form of a statement of terms and conditions. The home failed to include the fees payable within the terms and conditions in some cases. The service users representatives had signed them, indicating their agreement. There was evidence that the home had undertaken an assessment of the needs of service users on admission. They had also been provided with a summary assessment from the referring care management service, which they had used to form part of the information that contributed to their own needs assessment. The home did not admit service users for intermediate care. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home had failed to improve their procedures for administering medication placing service users at risk and of harm. EVIDENCE: A sample of the service user’s plans and supporting documentation, including risk assessments were reviewed and found to contain satisfactory information to help meet their daily needs. However, there was no evidence for those service users whose lives were case tracked, that they or their representatives had been consulted when the plans were drawn up. There was evidence that the service user plans were being reviewed, however not all supporting documentation had been reviewed at the same time as the care plan, therefore the supporting information was not clearly captured or had not been updated. Consequently, this created a conflict of information as the care plan did not always correspond and reflect the same health care support identified in the risk assessment, if the risk assessment had not been reviewed and updated. There was no evidence that the service user or their representative had been Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 11 involved in the reviews, or consulted about any changes made to the service user plan. Further development of the care plans were required to ensure that sufficient detail was included. Risk assessments with particular attention to the prevention of falls had been completed, but had not always been reviewed and therefore some information was out of date. The health care needs of the service users were generally met by the home satisfactorily. Further development was needed to ensure falls risk assessments were reviewed regularly and updated accordingly. Service users weight had been monitored which supported other nutritional records completed by the home. Evidence available supported the fact that service users were enabled by the home to access a variety of health care services, to meet their assessed needs. No service users were self-medicating at the time of this inspection. Samples of medication records, storage and procedures were checked, of those service users whose lives were being tracked as part of this inspection. All staff administering medication had received training. However, several areas of concern were found, including evidence that one service user had not received their medication for twelve days as the home had failed to obtain a prescription which they had been waiting for. One service users medication dose had been changed on their mar sheet by the homes’ staff, stating that this was changed by the GP (General Practitioner). However the home had no written evidence from the GP to support this change, which they had made to the mar sheet. The medication fridge temperatures were not being read correctly, subsequently the fridge was found to be too warm. Bottled liquid medication was not being date labelled when opened as a matter of good practise, therefore rendering the expiry date on the bottle obsolete. Several gaps were found on the medication administration records (mar’s), where staff should have signed to indicate whether medication had been administered; this was a requirement at the last inspection. The evidence from speaking with some service users, relatives & staff was that the service users were treated with respect and their rights to privacy were upheld adequately. However, further development was needed to ensure that sensitivity and discretion were considered when offering service users assistance to use the toilet. One staff member was observed encouraging a service user to go to the toilet in a corridor, in the vicinity of several other service users. The home had a death and dying policy and there was evidence that service users wishes, that in the event of terminal illness or death was recorded. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The meals in the home were satisfactory, offering a varied selection of nutritious and wholesome food. However the menu format required further development, to help service users to understand the menu choice they were making, to ensure they chose a meal they wanted. In addition, service users who may require assistance to eat, should be supported in a discreet and sensitive way to maintain their dignity. EVIDENCE: During the inspection some service users downstairs were observed in the morning and afternoon participating in planned activities. An activity plan was displayed and was available to examine. Individual service users social needs were included as part of the service user plan. There was some evidence that service users were given the opportunity to go on planned trips and outings, provided and arranged by the home; information was displayed. Minutes of the last service user meeting, which included relatives, were examined and detailed a review of a recent trip to Woburn and a clown show. The minutes demonstrated inclusion and consultation with service users and their relatives Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 13 to suit service users expectations and match their preferences with their capacities. However some activities observed did not appear meaningful, several service users were observed sitting in an area where modern popular music was playing on the radio station, which was tuned in. One staff member said that there was often very little time to support service users to pursue activities throughout the day, due to the level of physical needs of some service users and the subsequent time required to support them and the level of agency staff used, who may not always be as familiar with the service users or the environment. Staff meeting minutes demonstrated that there was an active keyworking system operating within the home, to support service users to meet their needs, which included social contact and leisure interests. Evidence suggested that service users were able to maintain regular contact with their relatives and friends without restrictions and were supported to maintain contact if they wished, by the home. Relatives who were spoken to during the inspection also supported the evidence and said they felt welcomed by the home when visiting and knew that they could visit at any time. Facilities were available to enable service users to receive visitors in private. The home was able to demonstrate that they supported service users to maintain as much choice and control over their lives as possible in most areas. Service users’ bedrooms were individualised with their personal possessions, which they were encouraged to bring in by the home. Observations were made over the lunchtime period during this inspection. There was no choice of menu offered for lunch on the day of this inspection, however the menu’s examined reflected a choice usually provided, which was changed seasonally. The menu’s generally offered a nutritious and wholesome diet to the service users, with a balanced and varied selection of foods. The menu’s were not written or presented in a format that was suitable for the capacity of all service users. Staff spoken to said they did explain the menu’s to service users and showed them the meals if necessary before serving them, to enable service users to maintain their choice. Service users spoken to said they enjoyed the meals at the home. Staff were observed assisting service users who required help, however further development was required in some cases to ensure that this was done in a discreet and sensitive way. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had satisfactory complaints and adult protection procedures in place, which ensured that complaints were listened to and service users were safeguarded from abuse. However some staff had not received POVA (‘Protection of Vulnerable Adults’) training, which could place service users at possible risk of harm or abuse. EVIDENCE: The home had received no formal complaints since the last inspection, but had received eight concerns, raised by visitors and relatives. A record was kept of all concerns & complaints. The home had a satisfactory complaints policy and procedure in place, which enabled them to deal with complaints received. Relatives spoken to were aware of the home’s complaints procedure and felt comfortable and confident to use it and that they would be listened to. The home had a Protection of Vulnerable Adults (POVA) policy in place, which included whistle blowing and staff spoken to demonstrated they were aware of the procedure. Most staff had attended POVA training, but not all. Since the last inspection there had been one notifiable incident in accordance with the POVA policy and guidance, which was reported to CSCI at the time. Evidence examined, supported a process that had been followed to safeguard and protect service users. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 15 Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home was satisfactory. However there were some identified risks, which need to be addressed, to minimize potential risk to service users and safeguard their health and physical wellbeing. EVIDENCE: The home had a part time maintenance person based at the home who followed a maintenance program. The grounds of the home were tidy, well maintained and allowed access to service users. Communal space was available within the home, which included an area service users could meet visitors in private and outdoor space provided for service users was accessible. Both areas were safe for service users to make the best use of them. A recently refurbished dedicated smoking room for Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 17 service users was available, which was adequately ventilated and a smoking policy was displayed. Dining room chairs had been replaced, to improve the quality of the homely environment. One specialist shower room that had been recently refurbished was unsafe for service users and for staff to provide assistance. The door panels into the shower area caused a potential hazard to staff when trying to provide assistance to service users. Talking to staff supported this evidence. Another bathroom contained a full-length blue plastic mat used to support and provide comfort for service users whilst in the bath. However, the sealed edges had perished and the internal foam contained stagnant bath water, which was being absorbed. This was removed as a result, during the inspection. Specialist equipment was provided and observed within the home to help maximise service users independence. This included different types of hoists, grab rails and assisted toilets and baths. However, the home had failed to ensure service users were safeguarded by observing regular visual checks to ensure the safety of hoist sling equipment, see ‘Management & Administration’ section of this report. Several bedrooms were inspected during the inspection and were all found to suit the needs of the service users. The décor was suitable and some redecoration in places was relatively recent. A program of regular redecoration of service users bedrooms was evident. Service users were given the opportunity to personalise their room with various furnishings, which the home had supported them to do. One service user said, “I am very pleased with my bedroom decoration, they have recently redecorated it.” However, several bedrooms were observed to have sink areas, which had ‘blown’ due to broken seals allowing water to seep into the wood. This caused effective infection control measure to be compromised. Safe systems were in place to ensure the homes heating and lighting was adequately maintained, which was evidenced by contractual arrangements. Water temperature checks were examined and evidenced that they had been recorded from all outlets and were satisfactory. The home appeared suitably clean and free from offensive odours, more suitable flooring had been fitted on the ground floor, which made the area appear clean & pleasant. Training records identified some staff that had undertaken infection control training. However further development was required in some areas to promote effective infection control practices. A wooden chair was in use in a bathroom, which was unsatisfactory practice. The homes laundry procedures did not comply with recommended infection control guidance for care homes. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provided sufficient numbers of staff to meet the needs of the service users. However further development was needed to ensure staff had developed individual training & development programs, to support them to meet the changing needs of service users. EVIDENCE: The home provided sufficient numbers of staff to meet the needs of the service users, which included a substantial number of agency staff in the staff numbers. On the day of the inspection there was one permanent care staff and four agency staff to meet the needs of twenty four service users, supported by one team leader. The manager said there was one hundred and twenty eight vacant care assistant hours per week, which were mainly being covered by agency staff. The vacant hours and positions were ‘frozen’, due to the potential transfer of existing staff from two other Luton Borough Council homes as a result of them facing imminent closure, which prevented the manager from recruiting. Training records detailed evidence that 50 of care staff had achieved NVQ level 2 or above. The homes’ recruitment procedures were satisfactory. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 19 The training provided was varied and relevant, which helped to enable staff to be competent to do their jobs. Staff members spoken to reported various training which they attended, including some recently. There was evidence that the home provides staff with ‘Skills for Care’ induction & foundation training, although these are not always completed within the ‘National Training Organisations’ (NTO) specified targets. The home failed to provide a structured training & development plan for each individual staff member, however a generic one was in place for the home. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some aspects of the homes health & safety and safe working practice procedures needed further development to ensure service users & staff would be protected from the risk of harm. EVIDENCE: The manager Maria Watkins was present for the duration of the inspection. The manager said that she had NVQ level 4 in both care and management and has completed her Registered Managers Award. The home did not have a fully effective quality assurance system in place. The manager said that surveys were conducted annually for service users. However, the statistics were not translated to anything meaningful and there Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 21 was no annual development plan from the results. Outcomes for service users were not identified, although the manager said that any items to be addressed were completed. There was no evidence that views of others such as GP’s, nurses and chiropodists had been sought. However, the manager explained that this area was currently undergoing further development and was being addressed demonstrated by training that the manager was scheduled to attend. Service users financial records and secure safekeeping of money and valuables, were being maintained satisfactorily on behalf of the service users by the home. The service users financial interests were safeguarded by the home, this protected the interests of the service user. There was some evidence observed within the home’s main kitchen and other areas of the home that safe food hygiene practices were not being consistently maintained by staff. Hand washing facilities were not prominently sited within the main kitchen, which did not promote effective infection control procedures associated with good hand washing practices. Hoist slings although serviced annually by the designated contractor, had not undergone any type of visual check by the home, as part of good health & safety practise procedures. Two slings were found to be unsafe and were removed from service during this inspection as a result. This was disappointing to find, as an accident had occurred within the home within the past year as a direct result of an unsafe hoist sling in use. Various records were examined to support adequate compliance with safe working practices, regarding health & safety. Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 2 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 2 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 2 1 2 X 2 2 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 X X 2 Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP2 OP7 Regulation 5 (1) (b) 15 (1) (2) (c) & (d) Requirement Timescale for action 30/04/07 3. OP9 12 (1) (a) 4. OP9 13 (2), 13 Service user contracts must include the amount and method of payment of fees. The service user plan must detail 30/04/07 the action and objectives that need to be taken by care staff to ensure that all aspects of the health, social and personal care needs of the service user are met. Service user plans must be completed with each service user or their representative and kept under review in consultation with the service user or their representative. The home must ensure that 09/03/07 service users receive all of their prescribed medications every day & that sufficient action is taken to ensure service users have not been adversely affected by the withholding of their medicines. A statutory notice enforcement notice was issued in conjunction with requirement 4. The staff administering the 09/03/07 DS0000033128.V308733.R02.S.doc Version 5.2 Laurels EPH Page 24 (4) (c) 5. OP9 18 (1) (a) 4. OP21 23 (2) (j) 5. OP24 23 (2) (b) & (c) 6. OP26 13 (3) 7. OP33 24 (1) (a) (b) medication must sign for all medications administered to the service users and must also indicate where medications are not administered. Previous timescales were not met, therefore a statutory enforcement notice was issued. The home must ensure that at all times suitably experienced and competent personnel administer medication and that they are sufficiently aware of their responsibilities to ensure that medicines are given as prescribed. A statutory notice enforcement notice was issued in conjunction with requirement 4. Safe and suitable bathing facilities must be provided to meet the needs of the service users. Repair or replacement of bedroom sink units, which are no longer sealed and have ‘blown’, rendering them unsafe and not fit for purpose, must be arranged and completed. The home must ensure that the spread of infection is controlled & minimized in accordance with relevant legislation and published professional guidance, with regard to laundering systems & procedures. An effective quality assurance system must be introduced as specified by this standard. 09/03/07 30/04/07 30/05/07 30/04/07 30/06/07 Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 25 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 The home should keep under review and where appropriate revise the statement of purpose and the service user guide. Information about the home including service user contracts & the service user’s guide, should be made available in formats suitable for each service user. The home should ensure the privacy and dignity of the service users at all times, including using sensitivity and discretion when offering assistance with personal care needs such as going to the toilet. Arrangements must be made to ensure appropriate opportunities are available for suitable stimulation and according to service users preferences. A menu to suit the capacities of all the service users should be provided to enable the service users to make a decision. Service users who may require assistance to eat, should be supported in a discreet and sensitive way. Regular, general visual checks should be made to ensure moving & handling equipment is safe and fit for purpose. 2. OP10 3. 4. OP12 OP15 5. OP38 Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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. Extracts may not be used or reproduced without the express permission of CSCI Laurels EPH DS0000033128.V308733.R02.S.doc Version 5.2 Page 27 - 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. 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