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Inspection on 26/07/05 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 26th July 2005.

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

Staff in both parts of the Home were observed caring for residents in a kindly manner and speaking respectfully and calmly. Residents and family spoken to said that overall they are happy with the care offered in the Home. Residents are offered a range of activities; for example a flower arranging session was held during the afternoon in Rednal. Although only a small number of staff questionnaires were returned these indicated that staff feel well supported by the manager of the Home. The information provided also indicated that the staff concerned have received recent training in core health and safety related topics. The cleaning staff were working hard to keep the house clean which is not easy when building and decorating work is taking place.

What has improved since the last inspection?

The home has commenced a programme of refurbishment that has enhanced sleeping, bathing and living accommodation and facilities for residents.

What the care home could do better:

The number of residents and lack of flexible communal space in Rednal Unit is a major factor in preventing a more individualised approach to care. Assessment information obtained for people moving into Rednal Unit needs to be more comprehensive to help staff understand what care and support the person needs when they arrive. This is particularly important when a person`s communication difficulties prevent them being able to tell staff what they need. Mealtime arrangements in both parts of the Home need to be improved to give people living at the Home a more enjoyable and relaxing experience and to ensure that they have all the help they need to eat their meals. Staff of all levels need more support to ensure that residents needs are met. The information in the care plans need to provide more detail to guide staff in giving residents the care they need. Areas of particular importance for improvement include important topics such as pressure area care, nutritional assessment and falls prevention. A number of residents were observed to be in stained clothing and dirty footwear. Staff in both units were seen lifting residents inappropriately indicating that more training and review of competence is necessary. The ongoing staff vacancy situation must be urgently addressed.

CARE HOMES FOR OLDER PEOPLE Lickey Hills Nursing Home (2 units) Warren Lane Rednal Birmingham, West Midlands B45 8ER Lead Inspector Chrissy Presley Unannounced 26 July 2005 09:45 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. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lickey Hills, Nursing Home (2 units) Address Warren Lane, Rednal, Birmingham, West Midlands B45 8ER 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) 0121 445 5532 Parkcare Homes (No 2) Limited Mrs Christine Alexander Care Home providing nursing care 97 Category(ies) of PD(E) Physical disability over 65 both genders registration, with number (97) of places PD Physical disability both genders (3) LD Learning disability both genders (4) OP Old age both genders (97) DE(E) Dementia over 65 both genders (47) Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Category LD (Learning Disability) is restricted to persons over 50 years of age Date of last inspection 10 February 2005 Brief Description of the Service: Lickey Hills Nursing Home is situated in a picturesque area of Barnt Green close to the Lickey Hills’ visitor‘s 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) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection commenced at 09.45 and was completed by 16.45. the inspection was carried out by two inspectors; one in each of the two units. Sub headings are used to help the reader see which information relates to which unit. Both inspectors spent time observing care practice including a mealtime. Care records were seen and a tour of the premises took place. In Cofton unit nine residents, three visitors and three care staff were spoken to. In Rednal unit the communication difficulties of residents limits the extent to which they can engage in conversation but the inspector sat and talked with one person and her visitors, spoke to another visitor and sat with one resident for part of lunchtime. Staff questionnaires and pre paid envelopes were provided for staff in Rednal Unit; five have been returned. Both inspectors spoke with the registered manager for the home, her deputy and the training manager. The inspectors acknowledge that the high level of staff vacancies in the home and the refurbishment programme are putting a strain on the registered manager and senior staff. What the service does well: What has improved since the last inspection? The home has commenced a programme of refurbishment that has enhanced sleeping, bathing and living accommodation and facilities for residents. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 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) E52 S4122 Lickey Hills (Rednal) V237160 260705.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 Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.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) 3 Residents on Cofton are assessed fully before admission to make sure the home can meet their needs. The assessments seen for recent admissions to Rednal contained insufficient detail to inform staff adequately about the person and their needs. EVIDENCE: COFTON: The inspector was informed that the original assessment of need document was kept separately from the care plan. An assessment of need document seen was comprehensive and contained enough information for a care plan to be formulated on the admission of any new resident. REDNAL: A tick box style assessment form was in use. The spaces for comments to be included to provide more detail contained minimal information. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 9 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 &10 Care plans did not always reflect current care needs and in some cases contained contradictory information; this reduces the effectiveness of care planning as a tool to help staff provide residents with the correct individualised care. Medication was not kept secure putting residents at risk. Screening in shared rooms did not ensure privacy for both residents. EVIDENCE: COFTON: Four care plans were inspected during the morning and although information in these had improved since the last inspection shortfalls in documentation were noted and care stipulated in the care plan was not always carried out. One resident was heard to ask for pain relieving medication and was told by a care member of staff to have their mushroom soup and some painkillers would be available after lunch; he did not fetch the nurse on duty. A number of residents were in their bedrooms on the day of inspection due to carpets being cleaned. Some did not have their call bell within reach and one was heard to be shouting ‘nurse’ to try and attract staff attention. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 10 There did not seem to be any leadership of staff and although staff were kind to residents their nursing needs were not being met. Residents commented on the high number of overseas staff employed in the home and their language difficulties. Inappropriate music and television programmes where residents were being nursed in bed was observed. Residents weights were not audited. Residents spoken to during the course of the inspection said they had not made a positive choice to share and were not happy with their current arrangement. The deputy manager did say to one resident she would have the next single room available. Screening in double rooms did not ensure privacy for both parties. Medication was stored in a lockable trolley; at lunchtime the trolley was wheeled into the lounge and medication was left on top of the trolley unattended during the lunchtime period. REDNAL: Care plans contained limited information about peoples care needs. For example in respect of pressure area care the plan for one person with a Waterlow score of 17 said ‘ X is at risk of developing pressure sore due to Waterlow of 17’ and ‘Proposed action – to prevent pressure sores developing’. There was also an issue about this person’s weight and there was a record of weekly weights being done but no nutritional assessment. An entry in May 2005 that the GP had prescribed a nutritional supplement was not mentioned in the relevant section of the care plan and there was no record of these being given. The care plan said the person should be given finger foods between meals but staff asked about this person’s food requirements did not seem to be aware of this. In another example one section of a resident’s care plan said they were ‘ fully mobile, she mobilises independently’ while elsewhere it said that she ‘is at risk of falls’ and ‘must be accompanied at all times’. The falls risk assessment was very limited and there was no indication that specialist input had been sought in relation to falls. Some examples of good observation and reporting were seen in the daily notes and staff were clearly working very hard to provide residents with as much attention as possible. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 11 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 The Home offers a programme of communal activities to residents on both units. Due to the numbers of people needing assistance mealtimes are not relaxed or enjoyable for residents. Relatives are made welcome when they visit. EVIDENCE: The Home employs a full time activities coordinator who works Monday to Friday and weekends if necessary. She also supports staff during meal times to assist residents with food. Records of activities offered to individual residents were seen in care plans in Cofton but not in those records looked at in Rednal. COFTON: During lunchtime a number of incidents were noted which upset other residents and were not noted by staff. A junior member of staff who was on an induction day was given food to give to a resident who displayed difficult behaviour, no support was offered by other staff members. Three residents were distressed at the behaviour of a resident sat at their table, staff did not respond. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 12 Two residents sat at a table were arguing; they were not separated and remained at the table for approximately one and a half hours. Staff were observed lifting residents inappropriately and not in accordance with the moving and handling care plan. Lunch offered was soup and a sandwich the main meal being served in the evening. The inspector was concerned at the amount of soup being given to residents in some cases this appeared to be less than half a cup. There were a high number of residents who required full assistance with food and staffing levels at this time did not meet resident’s needs. Special diets were catered for including cultural preferences. REDNAL: There were 43 residents living in Rednal unit on the day of the inspection. When the inspectors arrived many were at the table finishing breakfast. It was after 10am before they had all left the table. Two hours later at 12 o’clock, staff began to move people back to the table for lunch which staff began to serve at 12.30. There were nine staff to serve all 43 people most of whom needed help to eat. The meal consisted of soup, bread and butter and sandwiches and cheese on toast depending on the ability of residents to manage solid foods. The most dependent residents were served first meaning that a number of residents were sitting at the table for over half an hour before they were given their meal. All but 3 residents had their lunch at the table in the main dining area, one sat at a table on his own in another part of the room and two stayed in their armchairs with small tables in front of them. This meant that staff were each helping several people at the main tables and also needing to go back and forth to the three people sitting in the lounge area. One man sat in his armchair to eat barely touched his food and was attended to by staff just three times in half an hour because they were so busy. The process of serving people with their food was like a production line. Although staff worked calmly, patiently and efficiently there was little conversation with residents or explanation to people about the food being put in front of them. On a number of occasions staff were distracted from helping residents by needing to respond to things happening at other tables. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 13 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) Standards in this part of the inspection report were not inspected during this visit. EVIDENCE: Not inspected Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 14 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) 19 The building is being refurbished and when completed this will provide residents with more comfortable and attractive surroundings. It is unfortunate that an opportunity has not been taken to address the communal space in Rednal to decrease the institutionalised environment. There were a number of areas in the Home that had a malodour. EVIDENCE: The home has a major refurbishment programme currently going on, this includes fitting locks to bedroom doors, extra lighting in bedrooms, new bathrooms and shower rooms and upgrading of bedrooms. The inspectors noted that the locks fitted do not have door handles on the outside and therefore when closed are locked automatically – this means that residents unable to look after their own key would have to find staff to ask them to open their door for them. A number of rooms had a malodour. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 15 Environmental issues were noted and are covered in the requirements in this report. REDNAL: The sitting and dining areas for all the people who live in Rednal unit are in one large room. The armchairs are arranged in rows of up to eight chairs, some back to back, some facing people opposite. There is no personal space around the chairs – the arms of each one touching those of the next. The dining room has 11 tables all of which are very close together to get them all in. There is another dining table in the sitting area. There is nothing homely or welcoming about this room which is reminiscent of the style of communal rooms in long stay hospitals of the past. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 16 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) Standards in this section of the report were not inspected in depth, however there were clear indicators that staffing arrangements at present do not ensure that residents have all their needs attended to. EVIDENCE: Although none of the standards in this section was inspected in full, from observation at lunchtime there were not enough staff on duty to meet the needs of the current resident group. Staff on an induction day were not supported by more senior members of staff. The manager reported that staff vacancies are high with 14 whole time equivalent and 7 nurse vacancies at present. This is resulting in high use of agency staff and in regular staff working additional hours to provide adequate cover. A number of residents, visitors and staff commented on the inherent difficulties caused due to the high proportion of staff who do not speak English fluently. This was highlighted as a particular problem when communicating with people with dementia related communication difficulties and/or hearing impairment. The high usage of agency staff also affects the level of consistency that can be provided to residents. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 17 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) 38 The Manager of the Home has significant challenges to cope with as a result of staffing problems and the ongoing refurbishment. The Commission for Social Care Inspection will monitor the situation regularly. EVIDENCE: A number of health and safety issues were noted during the inspection and immediate and ongoing requirements have been made. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 18 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x 2 Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 19 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 14 Requirement The information gathered in the Homes own assessment before a person moves in must be more comprehensive in order to provide staff with a clear picture of the care the person is going to need. Residents requesting pain relieving medication must be assessed by the trained member of staff immediately Medication must not be left unattended Care plans must reflect current care needs and include sufficent detail to inform staff about all aspects of the care they should provide to each resident; nursing instructions written in care plans must be carried out. Areas addressed must include topics such as pressure area care, oral health, moving and handling, falls prevention and risk assessments appropriate to individual residents. ( Related requirements in the previous report were not met) The registered manager must ensure staff do not undertake unsafe moving and handling Timescale for action Immediate 2. OP9 13(2) Immediate Notice Immediate notice Immediate Notice 3. 4. OP9 OP9 13(2) 12(1), 15, 17 5. OP7 13 Immediate notice Page 20 Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 6. OP8 12(1) 7. 8. 9. 10. OP9 OP10 OP10 OP10 13(2) 12 16 12 techniques. (Requirement in previous report not met) The registered person must ensure care documentation for residents with diabetes includes details of normal blood sugar and blood sugar monitoring is carried out.( Requirement in previous report not met) Medication omitted must be written on the medication chart using the appropriate definition Adequate screening must be provided in shared bedrooms Residents who are able must be able to access a means of summoning help at all times Residents must have their dignity preserved at all times and must be offered clean clothing when they spill food or drinks Inappropriate music and televison programmes must not be played unless it is the residents choice and this is documented in the care plan Residents weights must be audited and nutritional assessments carried out and recorded for residents at risk nutritionally. Junior members of staff must be given more support when carrying out duties such as helping a resident with food More consideration must be given to those residents at mealtimes who are able to eat a meal and hold a conversation being mixed with residents who are less able and need more support. Residents must be offered adequate amounts of food More staff must be employed at Immediate Immediate Immediate and ongoing Immediate Immediate 11. OP10 12 Immediate 12. OP8 13 Immediate 13. OP15 18 Immediate 14. OP15 12 Immediate 15. 16. OP15 OP15 16 18 Immediate Immediate Page 21 Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 17. 18. OP19 OP19 23 16 19. OP24 12,13 20. 21. OP24 OP19 12,13 13 22. 23. OP19 OP24 17 16 24. OP27 18 25. OP38 23 26. OP38 18 lunctime to ensure residents are supported and given the time to enjoy their food. (Requirement in previous report not met) Firedoors must close on rebates Immediate notice The Home must address the Immediate malodours noted in some areas of the. (Requirement in previous report not met) Residents must have a lockable 30/08/05 storage space in their bedrooms unless the reason for not doing so is explained in the care plans Residents must be offered keys 30/08/05 to their bedroom unless a risk assessment suggests otherwise. Bolts must be removed from the 30/08/05 outside of doors; where doors need to be locked (eg cleaning stores), a suitable alternative must be provided. (Requirement in previous report not met) A record of furniture belonging to 30/08/05 residents must be kept All items of furniture specified in 30/09/05 Standard 24.2 must be provided in bedrooms occupied by residents. If the provision of any item poses an unaccpetable risk to the resident or they decline provision, details of the discussion and decision about this should be recorded in the assessment of the residents needs. Continued efforts must be made Immediate to recruit an adequate number of suitably qualified and experienced staff to work at the Home There must be evidence that all Immediate staff have received fire training or instruction at least every three months. (Requirement in previous report not met) Training records open to Immediate inspection must be updated Version 1.40 Page 22 Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc 27. 28. OP38 OP9 13 13 The named first aider on duty must be identified on the duty rota Requirements 10 and 11 in the previous report relating to medication will be reviewed by a pharmacy inspector in due course. Requirement 13 in the previous report regarding provision of drinks and snacks when residents wake not reviewed during this inspection. Requirement 16 in previous report regarding infection control arrangements not reviewed during this inspection. Immediate Requirements from previous report, not inspected at this visit. Requirements from previous report, not inspected at this visit. Requirements from previous report, not inspected at this visit. Requirements from previous report, not inspected at this visit. Requirements from previous report, not inspected at this visit. Requirements from previous report, not inspected at this visit. Requirements from previous Page 23 29. OP15 16 30. OP38 13 31. OP16 16 Requirement 18 in previous report regarding replacement of worn towels not reviewed during this inspection. 32. OP26 13,16 Requirement 19 in previous report regarding laundry upgrading not reviewed during this inspection. 33. OP30 18 Requirement 20 in previous inspection report regarding dementia training for staff not reviewed during this inspection. 34. OP30, 38 13, 18 Requirement 22 in previous report regarding moving and handling training not reviewed Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 during this inspection. 35. OP38 13,24 Requirement 24 in previous report regarding fire doors being held open not reviewed during this inspection. 36. OP25, 38 13 Requirements 26 and 27 in previous report regarding recalibration of hot water temperatures and recording bath temperatures not reviewed during this inspection. Requirement 28 in previous report regarding a raised door strip not reviewed during this inspection. 37. OP38 13 report, not inspected at this visit. Requirements from previous report, not inspected at this visit. Requirements from previous report, not inspected at this visit. Requirements from previous report, not inspected at this visit. 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. Refer to Standard OP3 OP15 Good Practice Recommendations It is recommended that the original assessment of need document is kept with care records for the first three months of admission Consideration needs to be given to mealtime arrangements in Rednal unit to make it more relaxed and to enable staff to give individual people more attention. Previous recommendations were not reviewed during this inspection - please see report on February 2005 inspection. Lickey Hills Nursing Home (2 units) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 24 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) E52 S4122 Lickey Hills (Rednal) V237160 260705.doc Version 1.40 Page 25 - 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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