CARE HOMES FOR OLDER PEOPLE
Linden Lodge Residential Home Browns Lane Dordon Tamworth Staffordshire B78 1TR Lead Inspector
Mr Kevin Ward Key Unannounced Inspection 12th December 2006 09:30 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 Linden Lodge Residential Home DS0000028077.V322626.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. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Linden Lodge Residential Home Address Browns Lane Dordon Tamworth Staffordshire B78 1TR 01827 899911 01827 899922 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) Mr David Charles Ms Deborah Frances Leyland, Mr Donovan Charles, Mr Mark Peter Davies, Dr Alan Roy Gummery, Ms Patricia McDonagh Mrs Charlotte Haynes Care Home 34 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (34) of places Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 13th December 2005 Brief Description of the Service: The home is purpose built and is registered to provide care to the older person and the older person with dementia (34 beds). The accommodation is provided over three floors, with the ground and first floor accommodating service users who require specialist dementia care. The majority of the service user accommodation is provided in single rooms. All rooms have good size en suite facilities. Lounge/dining and assisted bathing facilities are provided on each floor. The home is located opposite a small number of shops and close to the village amenities. A sensory room and accessible enclosed garden areas are provided to meet specialist care needs of the elderly service users. The current fees for the service range between £400 and £420 Care. This does not include person items, such as clothing that people are required to purchase from their personal monies. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection focused on assessing the main key Standards. As part of the inspection process the inspector reviewed information about the home that is held on file at the Commission such as notifications of accidents and incidents. A pre inspection questionnaire was also completed by the manager, which provided more helpful information about the home. The inspection involved meeting the people that live at the home and asking them for their opinions about the service they receive. The inspection also included talking with the staff on duty and the manager of the home and case tracking three people. This involves reading their care plans and checking how their care is provided in practice. Various records risk assessments, Quality assurance questionnaires, staff files and fire safety records were also sampled for information as part of this inspection. What the service does well:
None of the people at the home at the time of the inspection site visit had very high healthcare needs. Satisfactory care plans and risk assessments are in place for people containing adequate information and advice for staff to follow to meet people’s needs safely. Staff are being provided with dementia care training and the manager explained that she intends to introduce dementia care mapping in the near future. Entries in people’s records confirm that they are supported to gain access to local health services, such as GP, optician and chiropodists. People spoke very highly of the staff at the home and of the support they provide. People’s clothing was very clean and well laundered, indicating that a high priority is given to assisting people to look good and to retain a good selfimage. The home provides a good range of activities and outings for people and Christmas tunes were playing to help people to celebrate the Christmas season. Plans were also in place for carol singers to visit the home. People are encouraged to receive visitors and one visitor commented very positively on the welcome he receives, saying, “the staff are great”. A church service is held at the home every few weeks. The manager said that there was no one from other religions at the home or with any special cultural needs but indicated that the home would assesses and support people with such needs in the event that they wished to move to the home. People passed positive comments about the food provide at the home. The main lunchtime meal looked well cooked and was nicely presented to make it Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 6 appetising for people. The home takes account of people’s special dietary needs where necessary. Suitable arrangements are in place for storing and administering medication and a pharmacist visits the home regularly to audit the medication procedures to support safe practices. Overall the home is clean, attractively decorated and well furnished. There is good disability access throughout the home, including a lift to carry people to the upper floors and walk-in shower rooms on each level. The home has hoisting equipment in place for people with mobility problems who prefer a bath. The home has consulted well with the people living at the home and with their relatives and professional visitors so that there views may influence the service provided. What has improved since the last inspection? What they could do better:
There remains a need to improve the Whistle blowing procedures so that it is clear whom staff may contact in the event that they have any concerns about the running of the home that need reporting. The manager is recommended to devise written protocols for medications that people take on an “as required” basis so that staff are certain under what conditions the medication should be given, e.g. the use of inhalers. There have been no complaints since the last inspection but the manager is recommended to set up a complaints log for tracking the progress and outcome of any future complaints.
Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 7 The manager explained that people have been offered keys to their bedrooms but have declined them. Hence there is a recommendation for the manager to record these decisions or to write a risk assessment where it considered unsafe for someone to hold a key to their room. Training is being provided to staff to equip them for their work and to increase the number of staff holding National Vocational Qualifications, as currently this is low at 27 . The manager has agreed to check that there is always a member of staff who has had first aid training on duty and to arrange further training if necessary, to ensure that people’s welfare is properly safeguarded. In the main the recruitment process is satisfactory and checks are being carried out for new staff. However there remains a need to ensure that new staff do not start work before either the Criminal Record Bureau check or a POVA first check has been returned and checked. This is an important means of ensuring that staff are suitable to work at the home and that people are properly protected. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 8 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 Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are fully assessed and they are provided with information about the home to help them make an informed choice when deciding to move to Linden Lodge. EVIDENCE: A shift supervisor explained that people are encouraged to visit the home before moving in where they are able to do so. In many cases people’s relatives visit on their behalf in the first instance and are given information about the home to help them to decide if Linden Lodge is the place they want to live. An information booklet was seen, containing helpful information about the service people may expect from the home once they have moved in. A person who has moved into the home this year confirmed that he had received this information and another person explained that he had visited the home before moving in with the assistance of a nurse /care worker. This Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 10 person’s file was seen to contain an assessment of his needs, which has been used as the basis for his care plan. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with the support they require meeting their personal and healthcare needs in a manner that respects their privacy and dignity. EVIDENCE: Three people’s care plan files were sampled. The files contain detailed, helpful information explaining people’s needs. The care plans cover a suitable range of personal care need and health care needs, such as mobility, continence, eating and drinking etc. Various aspects of care are underpinned by risk assessments, e.g. risk of falling, skin care and where specific risks are identified, directions and guidance are in place for staff to follow. Comments by people living at the home indicate that they are involved in their care reviews and that their relatives are kept informed about changes and developments in their care. Good records are being retained of contact and consultations with people’s relatives. A visiting relative spoke in highly positive terms about the home and Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 12 the manner in which he and other family members are kept informed and involved in reviews of the person’s care. The manager stated that there are currently no people in the home that are bed bound or highly physically frail. The manager explained that where this occurs detailed monitoring records are maintained, e.g. turning carts and fluid records. Entries in people’s records confirmed that where required people receive visits from the district nurse. Currently this involves visiting to give insulin injections, enemas and to change one person’s leg dressing. The manager explained that where there are any concerns about peoples weight this is monitored. Evidence of this was seen in the care notes. Comments by an individual with diabetes and discussions with care staff confirmed that their diet is adjusted to take account of their condition, e.g. they are provided with low sugar puddings. Entries in peoples’ healthcare records demonstrate that they are supported to access support from local health services, such as GP, opticians and chiropodists. Discussions with a shift supervisor giving out medication indicated a satisfactory awareness of the home’s medication procedures. The medication was given out to people on an individual basis and signed for immediately in accordance with good practice. New medication received into the home is accounted for on the individual medication sheets and a returns book is in place to account for medication returned to the pharmacist. Comments by the manager and a shift leader confirmed that the home promptly returns unused medication back to the pharmacist to avoid stocks building up. The medication trolley was tidy and well ordered. The shift leader and the manager confirmed that the home does not currently hold any controlled drugs at the home. Comments by staff confirmed that they have been provided with medication training and the manager showed the inspector a competency checklist that she completes to check staff have understood the medication procedures. The manager agreed to devise written protocols for some “as necessary” medications so that staff are certain under what conditions the medication should be given, e.g. for use of inhalers. The pharmacist is carrying out regular medication audits at the home and reports are being kept on file. The people at the home spoke very positively about the staff that support them and of the care that they receive. Staff were seen to approach people in a friendly and respectful manner. The people living at the home looked very at ease and relaxed when requesting assistance from staff. People were seen to rise in an unhurried fashion and to be supported to enjoy a relaxed breakfast. Staff were mindful of peoples’ privacy and all personal care tasks were carried out behind closed doors so as not to compromise their privacy and dignity. A member of staff explained that she encourages people to choose their preferred clothing in the mornings. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 13 People were well groomed and dressed in clean well laundered, age appropriate clothing, indicating that appropriate regard is given to supporting people to retain a good self-image. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall people are offered a good range of activities and are provided with mealtime choices so that they enjoy the food provided and so that their nutritional needs are met. EVIDENCE: Comments by the people living at the home indicated contentment at the levels of activities and outings at the home. During the morning a member of staff was seen to play an organ and lead an old time sing song in the ground floor lounge which was enjoyed by everyone. Christmas music was played at other times and festive decorations and Christmas trees were in place on each floor, providing a pleasant Christmas atmosphere. A member of staff was also seen to chat and provide nail care in a relaxed and friendly manner. A monthly plan of activities and outings was seen in a sun lounge. A record of individuals’ likes and dislikes is available in their profiles and the activities organised try to meet these needs. Examples of activities that have taken place at the home include, Bingo, quizzes, dominoes, movement to music, board games, art and craft, library, visits to the zoo, garden centres and shopping. The home makes positive use of community groups, such as the
Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 15 carol singers and children’s’ school play. A representative from the Church of England runs a service every few weeks where a small number of people choose to attend. The manager explained that the home also has links with a congregational church. The manager said that a theatre trip is planned to the pantomime over the Christmas season for those who want to go to it. Comments by people living at the home explained that their friends and relatives are able to visit them when they want to do so. The manager confirmed that there is a flexible visiting policy in place. A visiting relative said that he is made to feel very welcome whenever he visits and commented on the friendliness of the staff at the home. Relatives are encouraged to take part in regular cheese and wine evenings at the home with the people living there. Comments by the people living at the home confirmed that if they want to talk to their relatives and friends in private they normally do so in their bedrooms. A member of staff confirmed that people are able to bring personal items of furniture and personal possessions with them when they move in, evidence of which was seen in the bedrooms. All bedrooms are fitted with locks and the manager said that keys are available for who ever wants them. The manager agreed to keep a record of people who have declined to accept the offer of a room key or write risk assessments where it is not felt to be safe for a key to be issued, as evidence that this choice is offered. Staff were seen to offer a choice of cereals at breakfast time. The breakfast time was a relaxed and unhurried affair and provided an opportunity for some people to chat together. Comments by people confirmed that they enjoy the meals provided by the home and are offered a choice each day. People’s likes and dislikes are recorded in their care profiles. The home’s menus are well balanced and nutritious. As previously noted, a person living at the home confirmed that the menu is altered to take account of his diabetic dietary needs, e.g. low sugar puddings. The manager confirmed that there are not currently any concerns for anyone suffering significant weight loss. The dining areas in the home are attractive and suitably furnished, creating a pleasant environment in which to eat. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 16 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Appropriate systems are in place for responding to people’s complaints and staff are trained to recognise and report suspicions of abuse. Increased information in the whistle blowing procedures is necessary to further safeguard the people at the home EVIDENCE: There have been no complaints made to the Commission for Social Care Inspection since the last inspection and the manager reports that there have been no complaints made directly to the home during the same period. Comments by the people living at the home and responses in the questionnaires that were sent to people as part of the inspection process confirm that they have been made aware how to complain. Information about how to complain was seen in the home’s information booklet that is given to people as part of the admission process. A copy of a letter was seen in the complaints log responding to a complainant with the findings of a complaint investigation. This indicates that the home now provides appropriate feedback to people in response to their complaints. Entries in relatives contact records indicate that the home is working well with relatives to address any concerns at an early stage before they develop into more serious complaints.
Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 17 Discussions with staff confirmed that they are provided with abuse training to help them to recognise and report any suspicions that come to their attention. A procedure is available for staff advising them how to report any suspicions of abuse, containing the contact details of relevant bodies. The whistle blowing policy is very brief and does not contain the details of people to whom staff should report any concerns about the running of the home, should this become necessary, e.g. General Manager, Social Services and the Commission for Social Care Inspection. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with a comfortable, clean and suitably equipped home that meets their needs. EVIDENCE: Overall the home provides clean and comfortable accommodation for people to live in. The home has accommodation on three levels and provides good disabled access throughout the building. The home has a shaft lift in place to safely transport people between the different levels and each floor has a separate bathroom and walk-in shower room. The lounge and dining areas are comfortably furnished and nicely decorated. The manager explained that all the bedrooms have recently been decorated. Eight bedrooms were viewed and found to be clean and fresh and each room Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 19 contained ample evidence to demonstrate that people have been supported to personalise their rooms, e.g. with pictures, ornaments and other belongings. Discussions with a member of staff and the manager confirmed that arrangements are in place for labelling and separating out peoples’ laundry so that it does not routinely get mixed up. Individual laundry boxes were seen to be in place to support this process. Protective gloves and clothing were available in the sluice rooms around the home. The manager explained that currently the home does not manage any continence laundry and that where this occurs it is sent to the organisation’s laundry at the Linden Lodge Nursing Home where they have industrial washing machines. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall the home provides suitably trained staff on duty in sufficient numbers to meet the needs of the people living there. The rating for this group of Standards is undermined by the practice of starting staff before all the necessary checks have been completed, ensuring their suitability to work at the home. EVIDENCE: Discussions with the manager and a sample examination of rotas indicated that there are typically two staff on duty on two living units and three staff on another floor, in addition to the cleaners and a cook. This was also confirmed in conversations with staff. Comments by the people living at the home indicate that the staffing levels are adequate and do not lead to lengthy delays in them receiving care support. Staff were seen to support people in an unhurried and friendly manner and to find time to engage in activities with them, e.g. nail care, and a sing a long. The manager confirmed that all the staff are over the age of 18 years and that no one under 21 years is left in charge at the home. A member of the home’s management team (i.e. manager or Care Supervisors) is on call at nights to respond to out of hour’s issues. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 21 The recruitment records of two recently employed staff were examined. The records demonstrate that people are required to complete an application form and attend an interview as part of the recruitment process to check their suability for the job. The records also demonstrate that the organisation checks individual identities and take up references and Criminal Record Bureau Checks. However it was noted that a member of staff has recently started work in advance of the Criminal Record Bureau check being carried out and without a POVA first check being taken up. A staff training matrix provided by the manager and comments by staff indicates that Health and Safety related training courses are provided to equip them to provide safe practices at the home. The manager explained that the organisation provides a range of Health and Safety training under the heading “mandatory training” in the home’s training matrix. The manager confirmed that staff are provided with food hygiene, fire safety, infection control, medication training in addition to some care courses, such as, dementia care, continence and optical awareness. The manager agreed to check that there is always a first aid trained staff member on each shift and to increase the number of people trained in this subject if necessary. The training records show that suitable management training courses are provided to the senior staff at the home. In the Pre-Inspection Questionnaire the manager reports that 10 care staff (27 ) hold a National Vocational Training Qualifications (NVQ’s) at level 2 or above. The manager also said that 6 more people are currently completing this training to increase the levels of NVQ trained staff at the home. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 22 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager takes account of the opinions of the people that live at the home, so that they are able to have a say in everyday issues that affect them. Suitable arrangements are in place for maintaining a safe living environment. EVIDENCE: The manager holds a nursing qualification and a diploma in dementia studies, in addition to the Registered Managers Award. The manager has many years experience of the care of older people and is well qualified for her role. Quality assurance questionnaires have been completed the people living at the home, their relatives and professional visitors. A sample examination of the completed questionnaires indicates that many positive comments have been
Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 23 elicited during the course of the year. The manager explained that she meets with relatives to discuss any issues they raise so that she can seek to address their concerns; evidence of this was seen in relatives’ contact records. The manager explained that she holds regular meetings with senior staff to address management issues in the home and to set up systems to address any shortfalls in the operation of the home. The records of these meetings verified that they are used to address a range of matters, such as, the rota, night staffing, relative contact sheets and dementia care mapping. As previously noted the pharmacist carries out regular audits of the medication. The manager confirmed that she does not act as appointee for any of the people living at the home and that this role falls to relatives or advocates to carry out. The manager explained that she approaches peoples’ relatives for money on their behalf and that records are kept at the head office, which is situated, in close proximity to the home, of how the money is spent. An itemised record of a person’s expenditure was faxed to the inspector providing confirmation that their money has been accounted for. In the pre-inspection questionnaire that was completed by the manager as part of this inspection, it is reported that the relevant Health and Safety checks have been carried out at the home. The fire safety records were sampled. The records demonstrate that the alarms and lights are routinely tested at the correct frequency and that fire drills are being carried out at the home. The records also show that the fire equipment has been checked and maintained in safe working order. A monitoring log is kept of hot water temperatures to ensure that the water is retained at a safe temperature level. The records also show that cold water outlets, such as showers are routinely flushed to reduce any potential risks of Legionella developing at the home. Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 3 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP18 Regulation 13S.3 Requirement The Registered Person is required to increase the level of detail in the whistle blowing procedures so that staff are clear as to whom they may raise any concerns about the running of the home and the welfare of people living there, should this become necessary. Ensure that there is a member of staff trained in first aid on each shift. The registered provider must ensure that all checks are made before new staff commence employment. Every staff member must have a Criminal Bureau Check or POVAfirst prior to employment. Outstanding from 12/1/06 Timescale for action 06/01/07 2 3 OP30 OP29 18 (1) (a) 19S.2 31/12/06 31/12/06 Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 2 3 Refer to Standard OP9 OP14 Good Practice Recommendations Devise written protocols for some “as necessary” medications so that staff are certain under what conditions the medication should be given, e.g. the use of inhalers. The manager is recommended to keep a record of people declining the offer of a key for their bedroom or write risk assessments where it is not deemed safe for people to be issued with a key. The manager is recommended to devise a record for logging and tracking all complaints made at the home. 4 YA18 Linden Lodge Residential Home DS0000028077.V322626.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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