Inspection on 24/10/06 for Layden Court Care Home

This inspection was carried out on 24th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Layden Court Care Home 19/01/06

Layden Court Care Home 29/12/04

Layden Court Care Home 29/06/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Layden Court Care Home All Hallows Drive Maltby Rotherham South Yorkshire S66 8NL Lead Inspector Claire McAuley Key Unannounced Inspection 24th October 2006 09:00 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 Layden Court Care Home DS0000003082.V311175.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. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Layden Court Care Home Address All Hallows Drive Maltby Rotherham South Yorkshire S66 8NL 01709 812808 NONE NONE 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) Tamcare Limited (a wholly owned subsidiary of Four Seasons Health Care Limited) Susan Storey Care Home 89 Category(ies) of Dementia - over 65 years of age (52), Old age, registration, with number not falling within any other category (17), of places Physical disability over 65 years of age (20) Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Service users within category OP are accommodated on Swallowood Unit Service users within category PD(E) are accommodated on Haighmoor Unit Service users within category DE(E) with nursing needs are accommodated on Kiveton Unit Service users within category DE(E) are accommodated on Becks, Thurcroft or Markham Unit One specific service user under the age of 65, named on variation dated 12th November 2004 may reside at the home. 19th January 2006 Date of last inspection Brief Description of the Service: Layden Court is an 89 bedded care home with nursing, which was purpose built and registered in 1995, and is situated on the outskirts of Maltby, near Rotherham. Residents are accommodated on three floors as follows: The lower ground floor has a 9-bedded residential EMI unit -Markham, for residents who have dementia but no nursing needs. This is closed at present due to reduced numbers, and residents have been transferred to Thurcroft/Becks unit. The ground floor has two units for residents in the category of old age: Swallow Wood has 17 beds for residents with general residential needs. Haighmoor has 20 beds for residents requiring general nursing. In addition there are two units on the upper floor offering care to residents with dementia including those with nursing needs. Thurcroft/Becks has 23 beds for residents with EMI residential needs. Kiveton, has 20 beds for residents with EMI nursing needs. The home has pleasant garden areas surrounding it and there is access to the gardens from each floor. There are local shops close by in Maltby, and a bus service operates nearby. The home is part of a group owned by Four Seasons Health Care. The weekly fees are from £340.20 to £495.00. The home charges extra for hairdressing, toiletries, and chiropody. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 24th October 2006 from 8.40 am to 5.10 pm. The inspector spoke to five residents, six members of staff, and the registered manager. A sample of records including menus, medication records, staff rotas, care plans, recruitment records, supervision, staff training, and procedures and policies were inspected and a proportion of the environment was checked. Four questionnaires from residents and three staff questionnaires were returned. What the service does well: What has improved since the last inspection? The care plans were in the process of being revised, to include more details of resident’s needs and the actions taken by staff to meet those needs. Supervision of senior staff was taking place at the required level and some progress in supervision of care staff had been made. An activities co-ordinator had recently been appointed and was beginning to develop a programme of suitable activities. A Deputy Manager had been appointed to cover the post, which had been vacant from July 2006. Staff had received training on Protection of Vulnerable Adults (POVA). The manager had obtained the Registered Managers Award qualification. The manager and a nurse had received dementia care mapping training and were introducing this to the home. Layden Court Care Home DS0000003082.V311175.R01.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. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in the outcome area is good. This judgement has been made using available evidence, and a visit to Layden Court. A statement of purpose service user guide was available for residents; to enable them to understand and decide whether the services the home provided met their needs. Residents were not admitted to the home without their needs being fully assessed. This ensured that their health, social, and care needs were met. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 9 EVIDENCE: The home had a service users guide/statement of purpose available for residents. This included some comments on the home made by residents. Two assessments of need were seen on plans of care. The manager confirmed that all residents admitted to the home had an assessment of needs completed before their admission. The manager completed assessments for self-funding residents. These assessments ensured that the service was appropriate for the resident and provided staff with the information to formulate an individual plan of care. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence, and a visit to Layden Court. Plans of care were in place for each resident. The information included was not detailed enough to ensure that the staff could fully meet resident’s needs. There was evidence that a range of healthcare professionals regularly visited the home to meet the resident’s needs. A policy, procedure, and training for the safe administration of medication was in place. Some errors in the administration of medication were found; therefore residents were not fully protected. Residents received personal support, which promoted their privacy, dignity and independence. However, staff said this was not always maintained because of staff shortages. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 11 EVIDENCE: Four care plans were checked in detail. They showed that a range of required information was in place. However, more detail in areas such as leisure interests, preferences, and accurate history of physical condition and changes to that condition was required. Risk assessments on falls required more detail on the prevention of falls. There were no formal reviews of resident’s needs, although the majority of care plans were updated. There was no evidence of consultation with relatives, and the residents or their relatives did not sign the plans. New person centred care plans were in the process of being introduced but had not yet been completed. Resident’s health needs were met, and the manager and residents spoken to confirmed that a number of health professionals visited the home. These included GP, chiropodist, dentist, and optician. Consultant psychiatrists had visited residents in the home’s dementia units. Specialist nurses advised on continence issues and pressure care. Some nutritional screening of residents was evidenced. There was a medication policy and procedure to ensure that staff adhered to safe practice. Four resident’s medication records were checked and their medication had been stored appropriately. One resident’s medication had run out, and the medication of a resident who had recently died had not been returned to the pharmacy. One resident’s medication was not administered according to the Medicine Administration Record sheet. Staff responsible for administering medication had received medication training. Staff spoken to were aware of the need to treat residents with dignity and respect and were observed interacting in a friendly and pleasant way with them. Staff said that they were sometimes unable to respond quickly to the residents call alarms, or requests for the toilet because of shortages of staff. Residents said they had not been offered keys to their rooms. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence, and a visit to Layden Court. Routines of daily living were flexible and suited residents individual choices and preferences. However, residents would benefit by the provision of more activities, and trips outside the home. Residents were supported in maintaining contact with relatives and visitors at any reasonable time. Resident’s choice was promoted by the personalisation of their rooms. Residents and staff complained about the food. Issues such as lack of choice, poor quality food, not enough food, and poorly cooked food, meant that the resident’s rights in regard to this were not promoted. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 13 EVIDENCE: Residents were observed choosing how to spend their day. The majority of those spoken to preferred to stay in their own rooms, reading the paper or listening to the radio or television. An activities co-ordinator had recently been appointed, and she was in the process of undertaking a programme of activities for residents. Staff said there had been few activities over the summer because there had been no co-ordinator in post. The home had no access to a minibus, and there had been few trips out in recent months. Staff sometimes took residents out shopping, in their own time. Some care plans had no record of resident’s interests and there were no individual plans of activities in place for them. Residents who returned questionnaires said that sometimes activities were appropriate. Activities included art, cooking, floor games and bingo. The records of these did not show who had taken part, and there was no programme of activities displayed at the home. The manager said that concerts were sometimes held at the home. Church of England Communion was held monthly, and resident’s religious needs were met as appropriate. The co-ordinator was still to assess the service users with dementia so that appropriate activities could be put in place for them. Visitors were welcomed to the home and residents were supported in maintaining contact with relatives and visitors at any reasonable time. Residents were able to personalise their rooms with items brought from home. This contributed to their comfort and well being, creating a homely environment in their rooms. All of the service users and staff spoken to said that the food was of poor quality, sometimes badly cooked, not attractively served, and that there was little choice of food. Two residents in returned questionnaires said they liked the food. Some staff said there was not enough food for residents. There was also a problem with the provision of a special diet where a resident was not offered sufficient choice, and was offered egg dishes at both lunch and tea time. Staff said that food left over at lunchtime was liquidised and served to residents on soft diets at teatime. Residents said they did not like the soup served at teatime as it was from a packet and was salty and thick. They also did not like sandwiches served so frequently. Cooked breakfast was offered only three times a week. Staff said that sometimes there were not enough staff to feed residents, as there were a high number of people who needed assistance on the dementia units. The menus seen appeared to be varied, and the cook confirmed that fresh vegetables were used. She said that residents were consulted about their preferences. The inspector observed that residents were not transferred from wheelchairs to dining chairs for their lunch, and some wheelchairs had no footplates. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence, and a visit to Layden Court. A complaints procedure was in place to protect residents but did not contain all of the require information in respect of timescales. This could result in complaints not being responded to in a timely fashion. Residents were protected from abuse by the awareness of staff through training, and the home’s procedure and policy. The staff would benefit from more training on dealing with resident’s challenging behaviour. EVIDENCE: A complaints procedure was in place at the home. It did not include the statement that complaints would be dealt with within 28 days. Service users spoken to said they would know who to complain to if the need arose. Since the last inspection there had been 3 complaints. Issues included, lack of staffing, poor standard of food, including lack of fresh fruit, laundry and loss of a wheelchair. The complaints records seen showed that complaints had been appropriately dealt with. At the previous inspection, it was highlighted that there had been a number of complaints about inadequate staffing levels. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 15 There was an adult protection policy and procedure that promoted the protection of service users from harm or abuse. Staff had received adult protection training including POVA. There had been two adult protection investigations; both were allegations that staff had abused residents. One of these resulted in a POVA referral, the other in a staff disciplinary. Staff confirmed that a number of residents presented challenging behaviours. One member of staff said that she had received training on challenging behaviour, but not all staff working on the dementia units had received this. There had been a number of thefts of resident’s money and possessions at the home, and also one incident of theft of Oramorph medication. These incidents had not been resolved and were still being investigated by the police. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence, and a visit to Layden Court. In the main, the home’s environment was clean, well furnished, and homely for residents. However continuing problems with the heating meant that some areas of the home were too hot. Some areas of the home smelled of incontinence. These issues could result in some service users being accommodated in an uncomfortable and unpleasant environment. Staff did not always have the right equipment to maintain hygienic and safe practice. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 17 EVIDENCE: The home’s environment was generally of a good standard. Lounges, dining rooms, kitchen, hall and stairs, and the majority of bedrooms seen were clean and comfortable, and were well furnished. The grounds to the home were well maintained and accessible to residents. The manager said she did not deal with the development or maintenance plan, for the home as this was dealt with by the regional manager. One toilet required redecoration and the toilet seat and toilet were stained. The temperatures on Thurcroft/Becks and Kiveton units were still too hot. This issue had not been resolved, and has been brought forward as a requirement from the previous inspection. In the main, the home was clean and pleasant, although two residents rooms and the top floor landing carpet had a strong odour of incontinence. Laundry facilities were sited away from food areas. There were policies and procedures in place for the control of infection and staff were aware of these. Staff indicated that there was sometimes a shortage of such items as gloves, wipes, aprons, and red and yellow disposal bags, to maintain proper hygienic practice, although the manager denied that this was the case. There were insufficent Kylies to meet the needs of the residents. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence, and a visit to Layden Court. There were insufficient staff employed at the home to meet residents needs. NVQ2 training at the required level had not been completed, and there was no formal induction which met Skills for Care standards in place, indicating that staff were not sufficiently trained to maintain a high quality of care. The recruitment procedure and practice maintained the safety of residents. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 19 EVIDENCE: All of the staff and residents spoken to said that there were insufficient staff employed at the home. One service user said ‘the staff have no time for you’; others said there was ‘never enough staff’. They said there were a lot of changes and they ‘never got anyone regular’. Three residents said that the majority of staff were very good, respectful and pleasant, but some were not. The home had four senior care staff off on long term sick, and this was the main cause of staffing problems. Staff members spoken to said that morale was low, that they did not feel supported by higher management, and they felt that the quality and continuity of care provided for residents was suffering. Staff were not always able to answer alarm calls or requests for the toilet promptly. Staff said that they covered a number of shifts where possible, but they were getting tired, some staff were working up to seven days of 13 to 14 hour shifts without a break. Staff rotas checked indicated that the majority of shifts were covered and a unit at the home had been closed to ensure that staffing numbers were maximised. However, it was clear that staffing numbers did not meet residents needs. The requirement to have 50 of staff trained to NVQ level 2 by 2005 had not been met. The manager stated that at present 19 of staff were qualified to NVQ 2 and 3. She said that 8 staff were to commence training in the near future. Four recruitment files were checked and the required information was in place, including application form, references, CRB checks, identification, and health checks. The manager said that new staff had an induction, which included information on health and safety, fire instruction, and principles of care. She said that staff shadowed a more experienced member of staff. The Four Seasons Induction did not meet the Skills for Care standards. Two staff members spoken to said they had received no induction when they started work at the home. Some additional training on specialised nursing techniques such as naso-gastric tube feeding had been provided, and two people had been trained on dementia mapping, and care plan development. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence, and a visit to Layden Court. The manager was qualified and competent to run the home. Residents were protected by the homes financial procedures. The quality assurance system did not adequately consult the residents or their relatives in order to measure the success in meeting the aims of the home. Supervision of staff was not completed at the required level and this could affect the health and welfare of the residents. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager was qualified and competent to run the home. She had recently completed the Registered Managers Award. The home had a quality assurance system in place which included quality audits of care plans, medication, the environment and the kitchen. Regulation 26 visits were undertaken. Residents had been asked their opinions of the service but results of questionnaires had not been published. A new revised questionnaire was in the process of being implemented. The manager said that relatives meetings took place two monthly, but these were not recorded, and sometimes, residents went to these meetings. Residents meetings were not held, partly because of the level of mental impairment that some residents had. The manager was not responsible for the annual development plan, which was dealt with from the regional office. This was not available at the home. Relatives dealt with the majority of resident’s finances. Two residents looked after their own money so they could purchase items such as papers, and hairdressing services at the home. Resident’s personal allowances were handled by the home’s administrator, and the regional support administrator was appointee to a number of residents. The home had a resident’s bank account. Accounts and financial records were kept, and these were appropriately recorded and audited. Financial reports were submitted to the Four Seasons organisation on a monthly basis. Senior staff had been supervised by the manager at the required level. However, care staff had not received the appropriate level of supervision. Nurses supervised care staff on a day-to-day basis, but those staff spoken to had received no formal written supervision or appraisal. The manager said that the new Deputy Manager had begun the process of completing supervision for care staff. This requirement is brought forward from the previous inspection. Staff had received the majority of mandatory training, including health and safety, moving and handling, fire and infection control. However not all care staff had received updated moving and handling, food hygiene, and first aid training. One staff member had received moving and handling training once in three years. Servicing and maintenance of electrics and equipment was in place, although some maintenance, and health and safety monitoring had been delayed due to sickness. COSHH assessments required updating. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 2 Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Care plans must be developed to include more detail of resident’s leisure needs and interests, and accurate monitoring of their physical condition. Risk assessments on falls and prevention of falls must be more detailed, and include measures taken to prevent falls. Residents care plans must be reviewed, and relatives and residents consulted in the process. Care plans must be signed by residents or their relatives/representatives, if they are not able. Resident’s medication must not be allowed to run out, and medication must be administered in accordance with the MAR record. Medication must be returned to the pharmacist after seven days following the death of a resident. There must be sufficient staff employed at the home to DS0000003082.V311175.R01.S.doc Timescale for action 01/05/07 2. OP7 13 15 01/03/07 3. OP7 15 01/03/07 4. OP9 13 24/10/06 5. OP9 13 24/10/06 6. OP10 18 31/12/06 Layden Court Care Home Version 5.2 Page 24 7. OP12 16 8. OP12 16 9. OP15 16 10. OP15 16 18 11. OP15 13 16 12. 13. OP15 OP15 16 12 16 18 14. OP15 12 16 ensure that resident’s calls for assistance are promptly answered. Records of activities must specify who took part. Care plans must include individual activities planned and provided for each resident. Activities programmes must be displayed at the home. The activities programme must be developed in consultation with residents and their relatives/representatives to provide more suitable activities, including particular activities for residents with dementia. Provision of food and menus must be reviewed, to ensure that a wide range of food is provided in sufficient quantities, is properly cooked and presented, and that residents are fully consulted on their choice of food. Cooks must be properly trained to be aware of special diets and provide a sufficient variety and quantity of appropriate foods to meet those resident’s needs. Food left over at lunchtime must not be liquidised and served to residents on soft diets at teatime. Residents must be offered a choice of cooked breakfast each day. There must be sufficient staff employed at the home to ensure that appropriate and prompt help is given to those residents who need help with eating. Residents must be transferred to dining chairs when eating meals. If residents are unable DS0000003082.V311175.R01.S.doc 01/05/07 01/05/07 31/12/06 31/12/06 24/10/06 01/11/06 01/12/06 24/10/06 Layden Court Care Home Version 5.2 Page 25 15. 16. OP15 OP16 12 13 22 17. OP19 23 18. 18. OP19 OP26 23 13 19. OP26 12 13 20. OP26 12 13 21. OP27 18 to transfer, or need a special chair to help them with eating, assessments must be made and recorded on their care plan. Wheelchairs must not be used without footplates. The complaints procedure must include the statement that complaints will be dealt with within 28 days. The registered person must reassess ways of alleviating the heating problems in two of the units in the home. (Timescale of 31/03/06 not met). The identified toilet must be redecorated and the toilet and seat replaced. The smell of incontinence must be eradicated from the home. Resident’s continence programmes must be reviewed and management of these issues improved. The manager must ensure that sufficient gloves, wipes, aprons, and disposal bags are always available for staff to ensure that safe and hygienic practice is maintained in the home. The manager must ensure that there are sufficient number of kylies provided to meet residents needs. The registered person must ensure that adequate staffing levels are maintained at all times (Timescale of 31/01/06 not met). 24/10/06 01/12/06 01/12/06 01/03/07 31/12/06 24/10/06 24/10/06 31/12/06 22. OP28 18 The registered person should 01/05/07 ensure that a minimum ratio of 50 trained members of staff NVQ Level 2 or equivalent is achieved. (Timescale of DS0000003082.V311175.R01.S.doc Version 5.2 Page 26 Layden Court Care Home 23. OP30 18 24. OP33 24 25. OP36 18 30/06/06 not met). An induction programme must 01/05/07 be provided for all members of staff that meets the requirements of the Skills for Care standards. The quality assurance system 01/05/07 must be developed to include regular consultation with service users and their relatives/representatives to ascertain their views on the service, including yearly questionnaires and regular meetings. Results of questionnaires must be published and made available to residents and service users. The registered person must 01/05/07 ensure that all staff receive formal supervision of at least 6 times per year. (Timescale of 31/01/06 not met). All staff must complete updated training on moving and handling, first aid, and food hygiene COSHH assessments must be updated. 01/05/07 26. OP38 18 27. OP38 13 01/03/07 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 Refer to Standard OP30 OP10 Good Practice Recommendations Specialist training including dealing with challenging behaviour should be offered to all staff working on the dementia units. Residents should be offered keys to their rooms. Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Layden Court Care Home DS0000003082.V311175.R01.S.doc Version 5.2 Page 28 - 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. 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