Inspection on 30/08/05 for Leopold Muller Unit

This inspection was carried out on 30th August 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Leopold Muller Unit 01/02/07

Leopold Muller Unit 18/01/06

Leopold Muller Unit 28/03/05

Leopold Muller Unit 25/08/04

Leopold Muller Unit 24/02/04

Similar services:

5 Seafield Road

Honeybourne House

Longrun House

Bodley Community Care Support Centre

Thomas Pocklington Trust

Chantry Gardens

Penkelly House

25-27a Alexandra Road

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

CARE HOMES FOR OLDER PEOPLE Leopold Muller Unit RNID Poolemead Centre Watery Lane Twerton BA2 1RN Lead Inspector Gillian Underhill Unannounced 30 August 2005 9:30am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Leopold Muller Unit Address Watery Lane Twerton Bath Bath & N E Somerset BA2 1RN 01225 332818 01225 480825 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) RNID Mrs Gill Harris Care Home With Nursing 22 Category(ies) of SI Sensory Impairment, 22SI(E) Sensory Impair registration, with number over 65, 22 of places Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 22 Patients aged 30 years and over with Sensory Deprivation, suffering from sickness, injury and infirmity Can include up to 5 Young Physically Disabled Persons Staffing Notice dated 03/04/2001 applies Manager must be a RN on parts 1 or 12 of the NMC register Date of last inspection 28-Mar-2005 Brief Description of the Service: Leopold Muller is registered to accommodate and support 22 service users with sensory loss deprivation, who have personal care and/or nursing care needs arising from sickness,injury and infirmity.There is special provision included in this number for 5 service users who require nursing care who are under the age of 50. The unit is situated in the Poolmead core site,together with other units providing registered care for a wide range of adults with sensory loss and other disabilities. Day services are also provided for service users,which focus on occupational,educational and therapeutic activities . Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over one day, and with contribution from the unit manager. A number of policies and procedures were examined, care plans and risk assessments were checked and staff consulted. Because of the sensory disability of the residents only 2 people were approached by the inspector, and asked if they were happy on the unit. Both confirmed they were and that staff were kind and helpful to them. Others were observed to be settled and relaxed in the presence of staff. None of the relatives of the residents were consulted but comment cards were left for their competition. What the service does well: What has improved since the last inspection? The manager said she does not offer a start date to newly recruited employees until police screening has been completed and CRB disclosures have been examined. A booklet on indicators of abuse has been made available to all staff, and likewise the unit’s policy and procedure on the Protection of Vulnerable Adults. Both documents have been placed on the staff notice board Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 6 for their observation. This demonstrates that the manager ensures as far as possible that residents are safeguarded from abuse. Since the last inspection morale has improved and staff say they have the full support and professional guidance from the manager. A team-building day held recently has promoted the well being of the unit, and assisted in generating a sense of renewed energy and focus. 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. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 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 standard(s) 1 & 2 Leopold Muller has produced a statement of purpose and residents guide which sets out its aims and objectives, including the range of available facilities. On receiving the documents, the relatives/ funding agencies will be able to make fully informed choices about whether or not the unit is suitable to meet the specific need of prospective residents. If the manager was issued with copies of residents contracts she would be fully aware of the contractual agreement between the funding agency and the RNID. EVIDENCE: Since the last inspection some slight amendments to the statement of purpose have been applied. There is a resident guide which is available to residents or their relatives, which has been provided in widget form. Both documents will be updated in January 2006, and will reflect any changes to the unit, including the new bathroom and toilet facilities. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 9 Copies of the contract between the RNID and funding agency have not been issued to the manager. This remains an outstanding requirement from previous inspections. Generic terms and conditions are in place and were examined by the inspector. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 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 standard(s) 7, 8, 9 & 11 There is every evidence that care is delivered in accordance with the residents care plan. The review process initiated by senior staff charts the residents changing needs, and highlights objectives for health and personal care updates where required. The plans are drawn up with the residents involvement where possible, but this very much depends on the level of the person’s cognitive ability and awareness. If care plans are developed in a format suitable for residents, then this will encourage a more active participation of some individuals in the care planning process. The manager ensures that residents’ health care needs are upheld in accordance with guidance and legislation. If a greater number of staff undertake training on Mental Health Awareness, then this will ensure residents with this condition benefit from experienced staff with a wider grasp on such conditions. Although the medication policies & procedures are detailed, the manager will need to review the documents to ensure that one single policy is in place which is specific to the unit, and makes reference to risk assessments, should a resident wish to self medicate. The RNID policy also states that two staff Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 11 members administer medication, when clearly this is not the case on the Leopold Muller unit. Because of the comments made regarding the length of time medication rounds take the manager has agreed to meet with the pharmacist employed by the commission in order to discuss this issue in some detail. Because of the training staff have received, residents can be reassured that at the time of their death, staff will ensure they are cared for with sensitivity and respect. EVIDENCE: During the previous inspection care plans were in the process of being updated, now a new format has been introduced, which includes reference to reviews, and risk assessments. Three care plans were examined, and each one was comprehensive in content, and contained Waterlow assessments, risk assessment for the prevention of falls, and moving and transferring risk assessments. Only one person has been given a copy of his care plan. The manager said that to date care plans have not been provided in a format other than the English word. There is evidence that informal reviews are now carried out on a regular basis, with outcomes recorded and these complement the formal review processes which occur annually or more frequently if the need arises. One resident has a wound care plan, which charts the wound healing process. Each resident has a pressure-relieving mattress, and no one on the unit has pressure sores. A psychogeriatian visits two residents, who have mental health needs, and monitors their wellbeing, and also advises staff on their support. The inspector was told that to date 2 staff have attended a two-day course on Mental Health Awareness. Each resident is weighed regularly. Only one person has been admitted to Accident & Emergency since the last inspection. Two medication policies were produced on the day of the inspection, which initially led to some confusion. One document has been developed by the RNID, and one more pertinent to the unit, prepared by the manager for Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 12 Leopold Muller. None of the residents self medicates, however there is a selfmedicating policy in place should anyone resident in the unit wish to accept this responsibility for their care. All MAR sheets were examined and were up to date and in good order. Only registered nurses administer medication, and during the inspection some trained staff said they found the medication round which takes up to two hours to complete, extremely time consuming, particularly as they are the most senior person on duty, and are sometimes approached by support workers for advise and guidance. None of the support workers have received medication training, and even though they do not have any responsibility on the unit for administration of medication, the manager feels that because they handle medication for residents on their trips out, they would benefit by increasing their knowledge base in this area. 90 of the staff team have received training on terminal/palliative care, and most of the residents have a funeral plan, which has been discussed with them or their representative on their admission to the unit, or during their review. The unit’s policy on death & dying was examined during the inspection, and was last updated in 2002. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 &15 Every effort is made by staff to ensure that activities and other pursuits matches the expectations of residents, and satisfies their social, and recreational interests. Residents receive a wholesome appealing balanced diet, in pleasant surroundings. . EVIDENCE: Residents have access to a wide range of activities and recreational pursuits, organised by staff and the activity coordinator, who has recently resigned form her post and will be leaving at the end of September. All activities are listed under 4 headings, textiles, craft, painting and miscellaneous, and are generally facilitated in the Educational Development Building, which at least 7/8 residents attend. An activity file is maintained, and the resident notice board lists the range of activities and outings in symbol format, which are available. Two residents have holidayed in Cornwall with staff support, and a trip to Weston –Super –Mare is planned for later in the month, along with a trip to Lego Land, and the Circus. A trip to the Theatre has been arranged in October for 8 residents. Six residents are to enrol at Bath College for a training course titled “towards independence”, which runs from September 05 to June 06. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 14 All meals are taken in the large Poolmead dining area, overseen by a catering manager who is able to communicate with residents in order to ascertain their individual likes and preferences. The menus on the dining tables clearly outline the available choices, but staff ask residents what food they would like the previous day. All of the residents require some supervision with feeding, but only one person needs full assistance. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 Because of the policies and procedures in place residents and their relatives can be confident that their complaints will be listened to, taken seriously and acted upon. Relatives need to be reminded of the unit’s complaints procedure during the residents review process. The manager ensures as far as possible that service users are safeguarded from all forms of abuse, in accordance with written policies. EVIDENCE: The unit has a complaints policy and procedure in place, which is in widget format, and has been supplied to each resident. Staff said they were aware of the RNID complaints policy, which they are asked to read and sign by the unit manager. The complaint log indicated that no complaints regarding service delivery have been made since the last inspection. The manager said that all staff has received POVA training, bar one person, however this was not consistent with the training matrix, which charts the number and type of training undertaken by staff. Those staff consulted, particularly the senior staff are aware of the POVA procedure, along with the RNID policy on the protection of vulnerable adults. Two CRB disclosures were examined for newly recruited staff, and the serial numbers were entered into a log, as is the required pratice. The manager said that no one commences into post until CRB disclosures have been returned and examined. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 16 The unit’s policy for the management of residents money has not been updated as required in the last inspection report, but instead has been passed to the regional director for action and to date remains outstanding. . Since the last inspection the manager said that no one on the unit requires any restraint, and therefore restraint training is unnecessary, other that the NAPPI training which all staff receive. A booklet titled “indicators of abuse” has been made available to all staff. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 21 & 26 Adequate toilet, washing and bathing facilities have been provided to meet the needs of the residents. The unit is kept very clean, hygienic and free from offensive odours. Systems are also in place to control the spread of infection. EVIDENCE: Toilet & washing facilities in the Leopold Muller unit are as follows: Ground floor- 3 toilets and 1 newly installed spa bath. Middle floor- 4 toliets, 1 disabled shower & bath, [shower room recently retiled, and new bath to be installed] Top floor – 3 toilets & I bathroom. [Disabled shower in the process of being installed.] There is a large laundry room on the main Poolmead site, which is fully operational. A laundry assistant is employed, but currently there is a vacancy for this post. Washing machines are accessible to residents, if they should wish Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 18 to wash items of their clothing, or if this is part of their independence programme. The sluice area is clean and free from any offensive odour. There are handwashing facilities around the unit. Most staff have completed infection control training at Bath College, and a number of trained nurses are soon to complete a decontamination course. There is a policy and procedure for infection control on the unit. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28, 29 & 30 Staffing levels will need to be kept under constant review, however even though comments were made regarding the busyness of the unit there was no evidence to suggest that residents needs are not met. Morale on the unit was good, and staff were confident and upbeat. … The recruitment process is robust, but the manger must ensure that all forms of staff identity remain on their file. A very comprehensive training programme has been made available to all staff. The 7-week aromatherapy course arranged for 10 staff is commended. If more staff were to undertake training on mental health awareness then residents in this category would benefit by appropriately trained staff. The manager should review the training matrix to ensure it contains up to date details of all training undertaken by staff. EVIDENCE: Although the duty rota evidenced that staffing levels were in accordance with the staff notice for nursing care, Some nurses said that the morning periods are very busy, largely because residents dependencies fluctuate,[there are 7 high dependencies currently on the unit] and also because medication rounds Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 20 can take up to two hours to complete. There is always one registered nurse on duty 7 days a week, 24 hours a day. Previously the manager said that she had requested additional funding to increase staffing levels during the night. This has not happened due to the lack of funding. Currently there are 3 bed vacancies. No one was in hospital at the time of the inspection. There is a deputy manager vacancy, which a senior nurse is covering, one nurse is on maternity leave, and one other person is about to take maternity leave. There are 2-f.t.e support workers vacancy, which are soon to be advertised. The manager said that approximately 1-2 agency nurses are used on a weekly basis. A domestic works Monday to Friday on the unit, but this person is currently off sick. Contractor cleaner are used during this period. There are no nurses employed from abroad who are undertaking an adaptation programme. The manager and one other person are NVQ assessors, and to date four staff have an NVQ at level 3. Eight staff have an NVQ at level 2. Six staff are currently doing NVQ training, and a further five, with four queries are soon to register. Two staff have recently been employed, and their recruitment files were examined on the day of the inspection. All necessary information had been collected, which included references, identification, qualification and employment history. A Probationary period is in place and formalised at three months of employment. CRB checks are carried out prior to candidates starting work. The manger is following the recommended practice of applying for POVA first and CRB checks for all new perspective employees. Both the staff training matrix, and 2 induction programmes was examined during the inspection. Both modules in the induction material had been fully completed and signed by the manager. The training matrix listed types of training undertaken by staff, both registered nurses and support workers. There was evidence that Registered Nurses have received Wound Care and Syringe driver training Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 36, 37 &38 The manager has ample experience in a senior management capacity, and has undertaken relevant training over the past 12 months to update her knowledge, skills and competence. The lines of accountability are clear and straightforward, and all staff are aware of the structure of the senior management hierarchy within the RNID and the unit. All staff are appropriately supervised. The record keeping on the unit has improved greatly over the past 12 months, and from the evidence produced residents rights and best interests are safeguarded by the unit’s record keeping, policies and procedures. A positive move has been made to ensure the health and safety of residents and staff by identifying two staff that have the responsibility for carrying out regular safety checks on the unit in line with recommended good practice. One support worker with this responsibility was consulted and was found to be knowledgeable and aware of the various tasks to be carried out. If this person were to receive training on health & safety his accountability regarding his responsibilities would be strengthened. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 22 While the use of heating triangles in the bathrooms is good practice, it would be worthwhile giving some consideration to the use of this equipment in residents bedrooms, in order to test the temperature of the hot water which residents have easy access to. It is of vital importance that all staff receive fire drills in order for the manager to determine their competence in the event of a fire in the unit. EVIDENCE: The manager has undertaken periodic training in the last 12 months, which includes conflict management, wound care & risk management. The registered provider makes regular visits to the unit, and produces a report of his findings, which is send to the Commission. Records indicate that the staff are involved in weekly team meetings, and have received supervision on a regular basis. Registered nurses supervise support workers, and the manager supervises all night staff. Records are maintained and supervisees receive a copy of discussions and agreements made during this process. Whole team meetings are held yearly, and 23 staff attended a recent team building exercise, which was held on the 8th August. No volunteers are used in the unit. The manager made all records required for the inspection readily available, and those records included the following: Residents records. Medication records Accident log Statement of Purpose Staff records Duty rota Complaints record Record of food Care plan Fire log. The majority of staff on the unit have received all statutory training, which includes first aid, basic food hygiene, and moving and transferring training. Hot water temperatures are controlled by thermostats, and heating triangles are used in bathrooms to test hot water temperatures. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 23 COSHH assessments have been requested by the suppliers of all chemicals used on the unit, and two staff have been designated to undertake health & safety responsibilities. All firebreak glasses are in the process of being renumbered. The fire log was examined, and offered evidence that staff receive fire training. The was no evidence that fire drills had been actioned in line with the recommendation as set out in the Avon Fire Log. All accidents and injuries on the unit are reported accordingly. All staff receive health & safety induction on recruitment into post. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x 3 x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x 3 x 2 Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 25 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4 Requirement A copy of the service users contract between the RNID and the service user must be made available to the manager.This remains an outstanding requirement. Staff to receive regular fire drills Timescale for action 28/10/05 2. 3. 4. 38 23 [4] 30/9/05 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. 6. Refer to Standard 7 8 9 27 38 38 Good Practice Recommendations Care plans to be developed in a format suitable to the needs of service users. A greater number of staff to undertake mental health awareness training. The units medication policy and procedure to be reviewed. Staffing levels to be kept under constant review. Health & safety representative to receive relevant training. Heat triangles to be used in service users bedrooms to safeguard against risks of scalding. Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 26 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire BS32 4RG 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 Leopold Muller Unit D56_D05_S20297_LeopoldMuller_V238813_300805_Stage4.doc Version 1.40 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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