Inspection on 13/06/06 for Linksway

This inspection was carried out on 13th 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Linksway 26/11/08

Linksway 23/11/07

Linksway 22/11/05

Linksway 11/01/05

Linksway 14/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Linksway Linksway Nursing Home 17 Douglas Avenue Exmouth Devon EX8 2EY Lead Inspector Michelle Oliver Unannounced Inspection 13th June 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 Linksway DS0000059789.V292055.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. Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Linksway Address Linksway Nursing Home 17 Douglas Avenue Exmouth Devon EX8 2EY 01395 263677 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) Alextour Limited Mr Nicholas Thomas Higgins Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Notice of Proposal to Grant Registration for staffing/environmental conditions of registration issued 10/7/98 22nd November 2005 Date of last inspection Brief Description of the Service: Linksway is a detached property standing in extensive grounds, situated in a residential area of Exmouth. The home provides accommodation for up to 24 people over retirement age. Service user’s accommodation is on the ground and first floor with a passenger lift between the two floors. Some rooms have ensuite facilities, some including a bath. There is a lounge on the ground floor. A second lounge/ diner on the first floor, currently being used as an office, can also be used as a function room by residents and relatives. There is ample parking on site. The home’s statement of purpose and service user guide is available at the home, which includes details about the philosophy of the home and details about living at the home. This is made available to all potential residents before they make a decision about living at the home. A copy of the most recent inspection report is available on request. Information received from the home indicates that the current fees are £500£805 weekly. Services not included in this fee include hairdressing, chiropody, newspapers and magazines and incontinence aids. Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over a period of nine hours. The manager and a provider were present for part of , and the deputy manager throughout, the inspection. During the inspection plans of care for 3 residents were looked at in detail. This enables helps us to understand the experiences of people using the service. A number of other residents were met and spoke with during the course of the day. The inspector also spent a considerable time observing the care and attention given to residents by staff. Several staff were spoken with during the day, including care staff, nursing staff and the registered manager. One relative was also spoken with during the inspection. Prior to the inspection 7 surveys were sent to residents to obtain their views of the service provided; 4 were returned. Comments were in the main satisfactory with the majority of the respondents confirming that they ‘always’ receive the care and support they need. 16 staff were sent surveys in order to hear their confidential views; none were returned. 6 health and social care professionals were also contacted prior to the inspection. The inspector toured the premises and a sample number of records were inspected including care plans, medication records, staff recruitment files, fire safety records and a record of accidents. What the service does well: All residents spoken with said they were very happy living at the home and the staff were helpful and kind. Staff work hard to ensure the well being and comfort of the residents and were observed treating them with great respect and kindness. Staff were able to discuss in detail how residents’ individual preferences are met at Linksway. A questionnaire completed by a relative stated that they were “delighted in the improvement, he has settled well and is eating again, staff have taken very great care of him. We could not ask for better”. Another stated that their relative “is very comfortable at this home and is well cared for” A resident commented “ we receive excellent support and care”. Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 6 The home provides well decorated, comfortable surroundings which are well maintained. The majority of the rooms are very spacious. Residents are encouraged to bring their own possessions, small items of furniture and ornaments to make their rooms their own. What has improved since the last inspection? What they could do better: The homes’ pre admission assessment should be sufficiently detailed to ensure that residents needs can be met at the home; current assessments lacked sufficient detail. Before making a decision to move to Linksway, people should be notified in writing, that their assessed needs can be met by the home. An assessment of any risks associated with the use equipment at the home must be undertaken before it is used. Residents must be involved, whenever possible, with decisions relating to their health and welfare. They must also be consulted about their social preferences and offered stimulation and encouragement to pursue previous hobbies or interests if they choose. Staff were able to discuss in detail how residents’ individual preferences were met but this information was not recorded in care plans. Residents are therefore at risk of not receiving consistent care in the way that they prefer. Care plans should be up to date at all times. If this is not so residents are at risk of receiving care that does not meet their current needs. Attention is needed to ensure that creams/eye drops are fit to be used and that eye drops are stored according to the manufacturers temperature range. Staff must ensure that they adopt safe recording procedures when hand writing medication records and must record the number of medication received for individual residents. A system should be established by the home to involve residents in the running of the home, seeking their views, and also for maintaining continued improvement in nursing standards. Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 7 All members of staff should receive a structured induction period to ensure they are competent to do their jobs. The registered manager should ensure that the management approach of the home creates an open, positive and inclusive atmosphere and should communicate a clear sense of direction and leadership which staff understand. 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. Linksway DS0000059789.V292055.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 Linksway DS0000059789.V292055.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Op3 & 6 Quality in this outcome is adequate This judgement has been made using available evidence including a visit to the service. Resident’s benefit from a generally good admission practice. Some improvement is required to ensure that all assessments are sufficiently detailed to reflect resident’s needs. EVIDENCE: Most of the residents at Linksway have lived there for a number of years and were unable to recall the actual process of moving there. Residents who have recently decided to live at the home were unable to recall the admission procedure. A visitor said that a member of staff had visited their relative at home, prior to admission, when their care needs were assessed and they were given information about the home. Four residents returned questionnaires before this visit; all said that they had been given sufficient information about the home before making a decision to live there. Three residents plans of care were looked at; all included a basic assessment of their health needs carried out before they made a decision to live at the home. An assessment that had recently been undertaken in response to a Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 10 recent enquiry from a person considering moving to the home, was looked at. This did not include sufficient detail to assess whether, or how, their needs could be met by the environment or staff at the home. For example, was the intended room suitable, were staff employed in sufficient numbers and sufficiently trained to manage the assessed needs. The assessment process is carried out to ensure that individual needs are known and that potential residents can be assured that they can be fully met at Linksway before deciding to live there. Potential residents are informed verbally that their needs can be met but not in writing The manager and staff said that family members and potential residents were welcome to visit the home, ask any questions, meet the other residents, if they are agreeable, and have a meal if they wished. All of the residents spoken to during this visit said that they were happy that they had decided to live at Linksway. Linksway DS0000059789.V292055.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Op 7, 8, 9 & 10. Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to the service. Residents benefit from an improvement in the care planning process at the home. Medication is generally well managed but attention is needed in two areas. Residents’ privacy and dignity are met and promoted by the staff and management at the home. EVIDENCE: All residents have a plan of care, three of which were looked at during this visit. Although staff were able to discuss in detail how residents’ individual preferences were met ,this information was not recorded in care plans. This puts a great responsibility on individual staff and potentially puts residents at risk of not receiving consistent care in the way that they prefer. There was no evidence of any achievable goals being set with the input of residents to maintain their independence. One care plan looked at was not up to date. The plan included information relating to the care of the resident that was not being carried out as the residents needs and capabilities had changed. Care Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 12 plans had been reviewed regularly, by staff at the home, with the involvement of residents. Assessments of residents nutritional needs, skin condition and risk of falls were included in individual plans of care. Some residents have rails attached to their beds to prevent them from falling. No assessments of the reason for their use or of the risk that the rails may present had been carried out. In one case several falls had been recorded for a resident who had climbed over rails attached to their bed, potentially putting the resident at risk.[ see standard 38] another resident spends time in a wheelchair when not in their room. It was noted that a seat belt was being used. There was no information in their plan of care of the risks associated with the use of a belt or the reasons for its use. There was a record of the resident falling when they stood up as “the seat belt had not been done up” A member of staff discussed plans to continue improving care planning. In response to a questionnaire sent before this visit a relative said that her relative receives “excellent support and care”. Feedback from GPs indicated that they were generally satisfied with the overall care provided to residents at the home. No residents are currently looking after their own medication at Linksway. The manager said that if a resident wanted to do this they would be supported a by staff at the home. During this visit the administration of medication was seen to be thorough and safe. Open containers of creams/ ointments with no indication of the date of opening/expiry, eye drops which were out of date and eye drops which were being stored at room temperature when the manufacturers recommendation was that they were to be refrigerated, were seen in resident’s rooms. Creams and ointments deteriorate once opened. Current practice puts residents at risk of infection and decreases the effectiveness of the cream. A record of medication that had been hand written did not include the amount of medication received at the home and had been signed by only one person;. a second person should check the accuracy of the recording to ensure that the information is correct. All residents confirmed that they are treated with dignity and that their privacy is respected by staff at all times. Staff were seen knocking on residents doors and waiting to be invited in before doing so. Linksway DS0000059789.V292055.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): Op 12, 13, 14 & 15. Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to the service. Social activities provided at the home are not creative nor do they provide daily variation or interest for people living at the home. Further consideration needs to be given to developing activities for residents who lack capacity. Meals are wholesome and nutritious, taking account of the likes and dislikes of individuals. EVIDENCE: The daily routine, including getting up and going to bed and mealtimes, appeared to be flexible. Several members of staff were concerned that vulnerable residents, who need assistance with eating, are given their lunch, routinely at 11.30 am when some of whom had been given breakfast only 2 –3 hours earlier. This was discussed with the person in charge who said that this was not always the case, that much depended on the number of residents needing assistance, but did describe the need for a certain degree of routine to accommodate staff working hours.[ see standard 26] Three residents, who responded to questionnaires, stated that there are usually activities at the home that they can take part in. One chooses not to take part but thinks that other residents enjoy them. Information received Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 14 from the home indicates that activities provided at the home include TV and radio, therapeutic music, guided exercise, books and games, animal sanctuary visits and Holy Communion. At the time of the visit one resident said how much they “enjoyed the exercise class on a Friday”. A record of interests and hobbies is recorded in individual plans of care but no indicators as to how these will be maintained or met. A record is not kept of any activities which may have been undertaken. A resident said that “ you just want someone to talk to, but staff are usually too busy”. Staff spoken to confirmed that they would like to have more time to spend with individual residents, to stimulate them through leisure and recreational activities. and that few activities were undertaken at the home. Several residents were very happy and content to remain in their comfortable rooms with their personal possessions around them watching TV or listening to the radio. Visitors are welcome at the home at any time but preferably between 11am – 7pm. Two visitors said how welcome they are made to feel when they visit the home and one often stays and has a meal with their relative. The home does not have a dedicated dining room. Residents are given the choice of being served their meals either in their rooms or in the lounge. The manager said that if residents requested, meals could be served in a room on the first floor which is currently being used as an office. During the visit fresh vegetables were seen and the midday meal was balanced and nutritious. The home caters for all dietary needs including vegetarian and diabetics. The menus offer a variety of meals on a four weekly rotation. A choice of meals is available at the evening meal but not at lunch time. Staff said that because the cook was aware of residents’ individual likes and dislikes an alternative meal would be provided for them if they didn’t want what was on the menu. Residents do not see a menu and said that they are not told what to expect for lunch. The menu does not clearly show whether a good standard of nutrition is provided, as it does not list vegetables on offer. The person in charge at the time of this visit confirmed that the menu would be amended to state that fresh seasonable vegetables are served with main meals. All residents said that they enjoyed the meals provided at the home. Linksway DS0000059789.V292055.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): Op 16 & 18. Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to the service. Residents are confident that they are listened to and their requests carried out. Arrangements for protecting residents and responding to their concerns are satisfactory. EVIDENCE: One complaint, relating to a staff issue , has been made to the Commission since the last inspection. This complaint was upheld. Residents confirmed that they feel comfortable discussing any concerns with staff at the home although they were unable to confirm that they had seen the home’s written policy. Residents responding to questionnaires said they “always” knew who to speak with if they were unhappy. There was nothing to suggest that residents are anything other than well cared for at Linksway. Residents said that staff were very helpful and respectful. Staff have undertaken Adult Protection and were able to discuss different forms of abuse. They all said that they would not hesitate to report any suspicion of poor practice. Linksway DS0000059789.V292055.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): OP 19 & 26. Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to the service. Residents are provided with safe, comfortable surroundings. Some infection control practices require some attention. EVIDENCE: Linksway is well maintained, with comfortable accommodation including two lounges, one of which is currently being used as an office. The home does not have a formal dining room. Residents’ rooms were homely and many had been personalised with their own belongings and some small items of furniture. The home is clean and pleasant. Hand washing facilities and hand sanitising gel is provided in all residents rooms and bathrooms. However, suitable arrangements are not made for the disposal of protective apron or gloves in some areas of the home. For example; bins are not provided for staff to dispose of aprons or gloves in an upstairs sluice or in the laundry. Staff Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 17 described the procedure for the disposal of aprons and gloves compromises infection control procedures at the home.[see standard 38] Call systems are fitted in all residents’ rooms. Not all residents who choose to sit in the lounge have access to a call bell. The staff said that usually a resident, who can reach the call bell, would do so for a resident who can’t. When residents are sitting in the lounge staff said that they frequently visit them to check that they were comfortable and safe. Staff responded to residents’ needs swiftly and efficiently throughout the inspection. The laundry room was generally tidy and clean. A sluice is fitted into the laundry room and at the time of this visit the room had an unpleasant odour. As resident’s laundered clothes are hung in this room there is risk of them also smelling unpleasant. This was discussed with the manager who spoke about the possibility of the sluice being re sited, but also confirmed that suitable arrangements would be made to ensure that freshly laundered clothes would remain fresh. Linksway DS0000059789.V292055.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): OP 27, 28, 29 & 30 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to the service. The number of staff on duty throughout the day and night meets residents’ health needs. Resident’s social needs are at risk of being compromised by the number of staff on duty during the afternoons. Residents are protected by the homes robust recruitment procedure. EVIDENCE: Residents said they were satisfied with the care they receive and that their needs are generally met. The number of staff on duty on the day of the inspection was sufficient to meet residents’ needs. The manager aims to have a registered nurse on duty throughout the day and night, 4 carers on duty between 8am-2pm, 3 carers between 2pm-8pm and 2 carer between 8pm-8am. The manager is also available at the home between 9am-5pm. The home employs a cook to work until 2pm daily. A kitchen assistant comes on duty at 5pm to assist with the evening meal. When feasible the evening meal is prepared by the cook during the morning so that care staff have to serve the meal. Staff expressed concern that they are not always able to provide stimulating activities or to spend time with residents during the afternoons. Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 19 Training provided at the home is limited. During the last 12 months staff have received fire safety, manual handling and prevention of adult abuse training. Information received from the home indicates that no training has been planned for the next 12 months. Staff spoke about areas of training which they feel they and residents would benefit from. This includes updating first aid, dementia care, infection control and basic food hygiene knowledge. Three members of staff currently hold an NVQ qualification at level 2 or above and one is seeking a training provider to enable her to complete training at level 4. As yet the target of 50 of care staff with NVQ 2 has not been achieved. Three staff files were looked at and all staff had been recruited using robust procedures to ensure the protection of residents. This includes obtaining Criminal Record Bureau (CRB) checks, two written references and a completed application form. Linksway DS0000059789.V292055.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): OP 31,32, 33, 35 & 38. Quality in this outcome is poor. This judgement has been made using available evidence including a visit to the service. There is no clear leadership and guidance to staff to ensure residents receive consistent care in a reasonably safe environment Residents are offered limited opportunities to be involved in the running of the home, there is little evidence that their views are sought. EVIDENCE: The manager has the required qualifications and experience to run the home. Staff spoken with described the manager as “approachable”, but that the management at the home has been “slack”. Staff are unsure whether issues which have been brought to the managers attention have been dealt with as they receive no feedback. These issues were discussed with the provider and a plan of action is underway. Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 21 The home does not currently have an established quality assurance system to ensure that residents will benefit from influencing the way the home is run. The manager and staff said that throughout daily contact with all residents their wishes and comments were noted and acted upon. The manager said that “nobody has ever asked for anything that the home doesn’t try hard to meet, we would go that extra mile to accommodate residents as much as possible”. Currently resident meetings are not held but this is something that would be considered in the future. The home plans to undertake a quality assurance survey soon. The home does not look after any monies for residents. this is undertaken either by the residents, their relatives or representatives or their legal advisors. Fire safety equipment, for example fire extinguishers, had been regularly serviced and the fire log showed regular checks and maintenance on emergency lighting and fire alarm. The pre-inspection questionnaire demonstrated that mandatory training, moving and handling and fire prevention training, is well managed at the home. Four members of staff hold a first aid certificate, which is due to be updated. Infection control procedures at the home are at risk of being compromised thereby putting residents at risk. The home does not currently have a satisfactory induction and foundation training and updates.[ see standard 30] Linksway DS0000059789.V292055.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 X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 3 11 3 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 1 X 3 X X 1 Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 23 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[d] Requirement Timescale for action 14/07/06 2. OP7 13[4][c] 3 OP7 12[2] The registered person shall not provide accommodation to a service users at the care home unless, so far as it shall be practicable to do so, they have confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. The registered person shall 14/07/06 ensure that unnecessary risks to the health or safety of service users are identified as so far as possible eliminated. [ this relates to assessments of the risks associated with the use of bed rails not being undertaken.] The registered person shall as 14/07/06 far as practicable enable service users to make decisions with respect to the care they are to receive and their health and welfare. [This is in relation to the use of bed rails with no evidence of service user involvement or DS0000059789.V292055.R01.S.doc Version 5.2 Linksway Page 24 4 OP9 13[2] consent] The registered person shall make 14/07/06 arrangements for the recording, handling and safe administration of medicines received into the care home. of medicines received into the care home. [this relates to: No record of the amount of individual medications brought in by a resident being recorded on a record of administration Ointments/ creams with no indication of their expiry date Incorrect storage of eye drops. Ointment being used past its date of expiry].] 5 OP12 16[2][n] 14/08/06 The registered person shall having regard to the size of the care home and the number and needs of the service users consult service users about the programme of activities arranged by or on behalf of the care home, and provide facilities for recreation. [ this relates to service users having the opportunity to exercise their choice in relation to leisure and social activities and cultural interests.] The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the home, including the quality of nursing care where nursing is provided at the care home. The registered person shall supply to the Commission a report in respect of any review conducted by him for the 14/09/06 6 OP33 24[1][a][ b] [2] Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 25 7 OP38 13[3] purpose of the above and make a copy of that report available to service users. The registered person shall make 14/07/06 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the home. 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 23 Refer to Standard OP3 OP9 OP12 Good Practice Recommendations The homes’ pre admission assessment should be sufficiently detailed to ensure that residents needs can be met at the home. Two members of staff should sign to confirm hand written information on medication records are correct All service users are given opportunities for stimulation through leisure and recreational activities in and outside the home which suit their needs, particular consideration given to people with visual, hearing or dual sensory impairment or those with physical disabilities. A menu, changed regularly, offering a choice of meals is given, read or explained to residents. Records are kept of food provided for residents in sufficient detail to determine whether the diet is satisfactory in relation to nutrition and of any special diets prepared for individual residents. Call systems with an accessible alarm facility should be provided in every room. Arrangements should be made to ensure that residents’ freshly laundered clothes are stored in a way that keeps them fresh. It is recommended that a strategy be developed to ensure that staff are supported and encouraged to obtain NVQ 2 or above and that timescales for meeting the standard are DS0000059789.V292055.R01.S.doc Version 5.2 Page 26 4. 5. OP15 OP15 6 7. 8 OP22 OP26 OP28 Linksway 9 10 11 OP30 OP32 OP32 agreed. All members of staff should receive a structured induction period to ensure they are competent to do their jobs. The registered manager should ensure that the management approach of the home creates an open, positive and inclusive atmosphere. The registered manager should communicate a clear sense of direction and leadership which staff understand. Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Linksway DS0000059789.V292055.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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