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Inspection on 20/06/06 for Lickey Hills Nursing Home (2 Units)

Also see our care home review for Lickey Hills Nursing Home (2 Units) for more information

This inspection was carried out on 20th June 2006.

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

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

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

What the care home does well

The units have a pleasant calm atmosphere, and the residents come and go as they please. In the warm weather they have free access to a safe, level enclosed garden. The staff are well trained and attentive to the needs of the residents. The managers are approachable and supportive to residents, relatives and staff. Relatives describe the staff as supportive and understanding, The health care needs of each person are well looked after and they are able to see doctors, chiropodist and opticians when necessary. Medication is well managed.

What has improved since the last inspection?

What the care home could do better:

The standard of recording pre admission assessments and nutritional assessments needs to improve so that staff have access to the information they need to care for new people, and care records on Cofton Unit requires improvement to ensure that safe, seamless care is provided. The recorded interests of individuals and provision of suitable activities and stimulation needs to be increased, and staffing levels during the evening and early morning periods require reviewing to ensure that residents` needs are met in a timely fashion.

CARE HOMES FOR OLDER PEOPLE Lickey Hills Nursing Home (2 Units) Warren Lane Rednal Birmingham West Midlands B45 8ER Lead Inspector N Richards Draft Unannounced Inspection 20th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.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. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lickey Hills Nursing Home (2 Units) Address Warren Lane Rednal Birmingham West Midlands B45 8ER 0120 445 5532 0121 447 7835 lickey.hills@craegmoor.co.uk www.craegmoor.co.uk Parkcare Homes (No. 2) Limited 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) Mrs Christine Alexander Care Home 97 Category(ies) of Dementia - over 65 years of age (47), Learning registration, with number disability (4), Old age, not falling within any of places other category (97), Physical disability (3), Physical disability over 65 years of age (97) Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Category LD is restricted to persons over 50 years of age. Date of last inspection 2nd September 2005 Brief Description of the Service: Lickey Hills Nursing Home is situated in a picturesque area of Barnt Green close to the Lickey Hills visitors centre. It comprises of two units, one catering for the elderly physically frail (Cofton Unit) and the other for people who have care needs arising from dementia related illnesses (Rednal Unit). Both units are on two floors and all rooms, single and shared have en-suite facilities. This report reflects inspections of both of the units in the home; sub headings are used in sections where the information is specific to one or other unit. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first key inspection of the service for the year 2006/07, and was undertaken by two inspectors, who spent a total of 15 hours on site. The inspectors assessed the care records for ten residents and spoke to four relatives, four residents and five staff. Administrative records and policies and procedures were also scrutinised. An examination of the physical environment was also undertaken. Informative communication with residents on Rednal Unit was not possible however the inspector spoke with several people during the day. Five staff were interviewed and their training records were assessed. A partial tour of the unit was undertaken and eighteen bedrooms were seen. What the service does well: What has improved since the last inspection? Since the last inspection there has been a refurbishment of Rednal Unit and Cofton Unit now has pleasant décor. Everywhere is clean attractively furnished and well maintained. The residents’ care plans on Rednal Unit are detailed and informative and all are regularly reviewed. Generally the standard of recording has improved. The staffing team has improved both in number and skill mix. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.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. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.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 Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.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): 2, 3 and 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The assessment records do not have the detailed information necessary to enable staff to provide the necessary initial care on admission. EVIDENCE: Ten sets of care records were assessed. All residents had been visited and assessed by a registered nurse before being offered a place in the home. This was confirmed by four relatives who said that they had also taken the opportunity to visit the home and received written and verbal information regarding the service the home offered. The amount of assessment information recorded was in the form of a tick list with a few comments. This was insufficient to enable an initial care plan of any value to be drawn up and inform staff. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 9 Residents or their next-of-kin had been given a written contract/statement of terms and conditions of the home explaining their rights and obligations. The home’s fees range from £448 per person per week to £485 per person per week. “Top up” charges are not made. The home does not provide intermediate care, so Standard 6 is not applicable to the home. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.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, 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff on Rednal Unit have access to developing care plans that are regularly reviewed enabling them to provide the health and social care each individual needs. However, the care documents on Cofton Unit were insufficient to enable care to be provided in a consistent manner. Where residents have not been assessed there is a risk that their nutritional needs may be compromised. Prescribed medication was well managed so that people received their medication safely and appropriately. Residents are addressed with respect and kindness. EVIDENCE: Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 11 Residents’ plans were maintained to a high standard on Rednal Unit. They were detailed and individual. All plans had been regularly reviewed. Care files examined on Cofton Unit failed to clearly and accurately specify the exact care to be provided to achieve the stated outcome. Some care files were contradictory. For example, one resident’s care plan cited “hourly checks during the night for his safety”, yet another care plan on the same care file cited “half hourly” checks at night. There was no supportive evidence to indicate that checks had been made in accordance with the contradictory instructions. The contradictory nature of the care documents indicates that nursing staff are using care records in a disjointed fashion, and failing to crossreference data recorded. Acute changes in health care needs were not being recorded in a satisfactory manner. For example, one person had been diagnosed with a chest infection. The care plan simply cited the objective as “To alleviate symptoms and treat accordingly”. The care instructions were scant and documented as simply to “Give prescribed antibiotics as per MAR chart. Monitor for improvement or deterioration. Ensure **** is well supported with pillow to allow good lung expansion. Refer to GP if condition worsens”. The documentation failed to indicate the provision of holistic care, and failed to describe clinical indicators of “improvement” or “deterioration”. This is of extreme importance as approximately 80 of hands-on care is provided by carers not registered nurses. The care plan had been written on 10/06/06 and had not been reviewed. It had been discontinued on 17/06/06. Some information contained within care plans was incomplete. One resident’s care plan contained the instruction to “Nurse *** in a ….”, while another care plan cited “Check *** hourly when in his….”. The same person was cited as having a depressive condition. The care plan was clinically negligent, and failed to safely address the problems associated with depressive states. Wording was vague. For example, one outcome was recorded as “To provide optimum standard of living”. It is uncertain what this means, or how it could be measured. There was no assessment of risks associated with self-harm. A subsequent care plan for the same person identified cancer of the prostrate as a care need. This had not been linked in with concerns about the person’s depressive state, and the care plan made no mention of the person’s emotional well-being. The plan of care simply focused on urinary output. One resident was receiving regular dialysis. There was no care plan in place for this health need. Another resident was experiencing dementia. The care plan was vague and confusing. Instructions recorded in the care plan included; “Establish a therapeutic relationship based on trust…Approach him in a calm manner and use therapeutic touch”, and “…maintain optimum level of wellness”. When asked, staff did not appear to understand what these “instructions” meant. The inspector was also rather confused about the documented instructions. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 12 Care records had not been countersigned by the resident or their nominated representative. Daily records were clear and informative. A detailed nutritional assessment had not been carried out with all of the residents who were case tracked. More written information was needed regarding the religious support that some people wanted and their end of life wishes. It is acknowledged that this is a sensitive subject that some relatives find difficult to face. Residents were observed to be clean and appropriately dressed. Those residents with pressure sores were receiving the relevant treatment and one relative said that her relative’s sores had improved since she moved into the home and she was impressed by the staff, who ensured that everyone on Rednal Unit was given opportunities to move around the home for their health and mental stimulation. Pressure care assessments and care plans on Rednal Unit were well recorded. Care records indicated that the general practitioners and hospital doctors were consulted when necessary, and relatives confirmed this. Chiropodists and opticians had also visited. Medication was well managed. Relatives confirmed that they had been kept informed regarding the prescriptions, and received explanations about the medication prescribed. Storage and records were well maintained. Privacy and dignity was respected. All records contained a signed consent form permitting the staff to attend to residents’ mail. Special locks were fitted to bedroom doors which removed the risk of the resident becoming trapped, but protected the resident from unwanted intrusion. All staff were seen to knock on doors before entering bedrooms. Relatives described the staff as ‘so good’, ‘excellent’ ‘very attentive’. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents have no access to a suitable selection of activities and stimulation. Residents’ religious needs are being met and they have ready access to their visitors. Meal times are pleasant and well managed, with good support and preferences being served. EVIDENCE: It was acknowledged that the residents’ ability to participate in organised activities was limited. However there was little evidence of residents’ past and current interests in some of the records and the records of participation was limited and ceased in December last year when the activities organiser had left. Relatives said that they had “seen no evidence of activities and stimulation when they had visited but this could have been that it was the wrong time of day”. It was observed that there were decorations that reflected the ‘world cup fever’, and the unit manager (Rednal Unit) said that everyone had enjoyed the Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 14 party atmosphere generated when they watched the television and seen England play. Interaction between residents and staff was continuous. The unit manager said that the activities organiser had now returned and had an assistant so a fresh programme would commence and records would be maintained. Because of the residents’ abilities there was little interaction in the community although the vicar and a lay pastor regularly visited the home and the home was well supplied with hairdressers. The residents’ relatives generally managed personal finances. One set of records was seen for money held in safekeeping and this was well managed. Most residents dined in the dining room. Staff tried to seat people together according to their abilities so that they benefited from social interaction. A member of staff was allocated to each table to assist and encourage as necessary. The staff were then able to monitor what nutrition and fluids each person had consumed. Lunch was a light meal of soup, sandwiches and baked potatoes. The main meal of the day was served in the evening. The staff made a choice for each person based on previous observations of enjoyment. Residents appeared to enjoy their food. One resident interviewed described the food as “wonderful”, while another person said (it’s) “not as good as home cooking, but it’s ok…If it’s not on the menu, they’ll get it for you”. The atmosphere was calm, quiet and unhurried. Relatives said that they had seen the menus that were displayed and they always looked good. One person commented that her relative had put on weight since she had moved in. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Relatives receive the information they need to make a formal complaint and staff know how to advise and support them as they have received appropriate training. EVIDENCE: The Statement of Purpose and Service Users’ Guide contained copies of the complaints procedure. Relatives said that they had received copies of these documents The complaint record contained one entry that had been appropriately dealt with. Training records indicated that staff had received instruction in Equal Opportunities, The Protection Of Vulnerable Adults and Prevention of Violence. The staff confirmed this and they were aware what action they should take if they received a complaint or identified a concern. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.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, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a well decorated and furnished home, and have comfortable, pleasant bedrooms. The dining room on Rednal Unit is overcrowded, and the main lounge on Rednal Unit is too large to meet the needs of people with dementia conditions. Communal space on Cofton Unit is suitable for the needs of residents. The infection control systems in place minimise the risk/s of cross infection and contamination. EVIDENCE: A tour of the home was undertaken, and a total of eighteen bedrooms were seen. All areas examined were clean and attractively decorated. Some minor Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 17 repairs were required and the handyman was attending to these at the time of inspection. Each Unit possess a book for minor repairs, which the handyman examined on a daily basis. The dining area on Rednal Unit was too small, and over-crowded for the number of people who used it. The lounge area on Rednal Unit was a very large room that did not lend itself to the specialist care needs of the residents. However efforts had been made to divide the room into small seating areas, which reduced the overwhelming sense of space. Further attention needs to be given to the size, design, furnishing and layout of the communal area on Rednal Unit to try and make the area more homely, and minimise the institutional impression the area generates. Residents had easy level access into a small attractive enclosed garden and were able to wander in and out as they pleased. Toilets and bathrooms were equipped with liquid soap and disposable towels and staff confirmed that aprons and gloves were readily available. The laundry was clean and tidy. Staff said that they had received training in Infection Control and their certificates were seen. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.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, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally, there are sufficient, well trained staff to provide the care the residents’ need. Staffing levels in the early morning and evening periods need to be reviewed to ensure that residents receive their care in a timely manner. EVIDENCE: The visit was conducted with the assistance of the unit manager on Rednal Unit, and the inspectors interviewed four staff and spoke to several others. The duty roster indicated that during the day, each unit was staffed by ten nursing and care staff during the first half of the day and nine nursing and care staff during the second half of the day. At night there were five staff at work on each unit. The team was comprised of a mixture of men and women of a wide age range. This enabled residents to respond to those with whom they felt most comfortable. It was observed that the staff were continually with the residents assisting and interacting with them. This was commented on by a relative who said that all the staff were there with the residents and were aware of what was going on. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 19 Another person said that the staff were “wonderful... Nothing was too much trouble for them.” Nursing and care staff on Cofton Unit were interviewed. The general consensus of opinion was that there were sufficient staff on duty during the daytime, but between 6pm and 8pm the workload “increases significantly” and staff have to work harder as there are a high number of people (approximately 20) who require assistance with their meals. Staff believe that an additional two carers between the hours of 6pm and 10pm and between 7am and 10am would help to deliver care in a less hurried manner. The staff said that they were confident in their work and received regular training. Their training records that included induction training, core subjects and specialist subjects such as dementia, peg feeds and stoma care confirmed this. Regular supervision was given by a senior member of staff and these were considered to be very useful in helping to maintain standards and develop skills and knowledge, and discuss proposals to develop and improve the service. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.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, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is appropriately managed, and provides care in a safe environment. EVIDENCE: The home manager was skilled and knowledgeable. The staff said that they found her approachable and helpful. Relatives found her excellent and willing to make a huge effort with the residents. The unit managers were observed to relate well to the staff and communicate well with visitors. They were observant and took immediate action when they noticed anything that needed attention. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 21 Relatives assisted most residents with their personal monies. The interests of those residents who had monies held in safekeeping were safeguarded through meticulous recording and safe storage. Staff undertook fire safety training and drills. Systems were regularly tested and results recorded. Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.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 X 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 23 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 OP3 Regulation 15 Requirement The outcome of pre-admission assessments must be recorded in sufficient detail to inform staff of each person’s known needs, and enable an initial care plan to be drawn up before they arrive in the home. Care plans must be developed to include the care required to meet the assessed needs of residents. Care plans must be formally agreed either with the resident, or with their representative when the resident is unable to provide informed agreement. Care plans’ effectiveness must be reviewed in accordance with the changing needs of each resident by a registered nurse. Care plans must be written to ensure staff understand the care to be provided, and to ensure that care is provided in a consistent manner. Nutritional assessments must be undertaken in depth as soon as possible after admission certainly within the first week, and a care plan formed if DS0000004122.V300705.R01.S.doc Timescale for action 20/06/06 2 3 OP7 OP7 15(1) 15(1) 14/07/06 14/07/06 4 OP7 15(2) 14/07/06 5 OP7 15(1) 14/07/06 6 OP8 14 20/06/06 Lickey Hills Nursing Home (2 Units) Version 5.2 Page 24 7 OP12 16 8 OP20 23(2)(a) 9 OP27 18(1)(a) 10 OP27 18(1)(a) 11 12 OP30 OP30 18(1)(a) 12, 18(1)(a) 12, 18(1)(a) 13 OP30 14 OP30 18(1)(a) necessary. Residents’ interests must be recorded, and they must be given opportunities for stimulation through leisure, social, occupational and recreational activities, which suit their individual needs, preferences and capabilities. The size, design, furnishing and layout of the communal area on Rednal Unit must be reviewed to make the area more homely, and minimise the institutional impression the area generates. Staffing levels between 7am and 10am and 6pm and 10pm must be reviewed to ensure that residents’ care needs are being met by care staff in an unhurried manner. Continued efforts must be made to recruit adequate numbers of suitably qualified staff to work in the home. Training records open to inspection must be updated. There must be evidence that staff have completed an induction programme relevant to the post they hold in the home. There must be evidence that staff have completed a foundation programme relevant to the post they hold in the home. Induction and foundation records must evidence these programmes have been completed. 20/07/06 30/09/06 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 31/08/06 Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.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. Refer to Standard Good Practice Recommendations 1. 2. OP8 OP30 It is recommended photographs of pressure areas and wounds are photographed with residents consent The company should consider employing a training officer full time Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Lickey Hills Nursing Home (2 Units) DS0000004122.V300705.R01.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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