Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Littledene House 54 Bushey Grove Road Bushey Hertfordshire WD23 2JJ zero star poor service 17/11/2008 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Patricia House Date: 0 8 0 4 2 0 0 9 Information about the care home
Name of care home: Address: Littledene House 54 Bushey Grove Road Bushey Hertfordshire WD23 2JJ 01923245864 Telephone number: Fax number: Email address: Provider web address: m.ang@btopenworld.com Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ms Margaret Ang care home 12 Number of places (if applicable): Under 65 Over 65 12 12 dementia old age, not falling within any other category Conditions of registration: 1 0 If the names service user ceases to be accomodated at the home then the variation to the category shall cease. The home may accommodate one named service user under the age of 65 with Dementia. The manager must inform CSCI if the service user permanently leaves the home for any reason. Date of last inspection Brief description of the care home Littledene House is a care home providing personal care and accommodation for twelve elderly people who may also have a dementia. Littledene is privately owned and the proprietor also manages the home. The property is a large detached house, which has been converted to provide single room accommodation. Six of the bedrooms have Care Homes for Older People
Page 2 of 19 1 7 1 1 2 0 0 8 Brief description of the care home en-suite toilets. The house is well presented and provides residents with comfortable surroundings in a homely atmosphere. There is a passenger lift for easy access to the upper floor and an enclosed garden to the rear. The frontage of the property is attractively paved and allows for the parking of several cars. A single storey extension at the back of the house provides living accommodation for three members of the care staff. Littledene is situated in a quiet residential road in the village of Bushey and is approximately two miles from the village High Street and also about two miles from the extensive amenities of Watford Town. There are local shops a short walk away. There are nearby bus and rail services and the home is close to several major roads and motorways. Current charges for the home range from £495.00 to £609.00 per week. Further information can be found in the homes Statement of Purpose and the Service Users Guide, which are displayed in the entrance hall together with the last CSCI inspection report. The home also has an internet web site. Care Homes for Older People Page 3 of 19 What we found:
The last key inspection of the home took place on 12th and 17th November 2008. This inspection took place in order to assess the progress made in implementing the requirements made in the report of the last visit and also as a result of concerns raised about the night care provided at the home. The inspection took place on one day, starting at 5.45 am, with two regulation inspectors carrying out the work of the Commission. For the purposes of this report the Commission will be referred to as we. There was one care worker on duty when we arrived at the home on 8th April. The manager came on duty at approximately 7am. There is an on-going investigation taking place about the home under Hertfordshire County Council Adult Care Services joint agency safeguarding vulnerable adults procedures. As a result of information provided during this investigation, we visited the home again on 30th April and made an additional immediate requirement. Compliance with some of the requirements made in the report of the previous inspection were not checked on this occasion and and have been carried froward in this report. Some requirements made at the previous inspection were assessed on 8th April but were not met. The Commission is now considering enforcement action. What the care home does well:
We saw a wide range of equipment and pictures which had been provided at the home since the last inspection. The manager has provided pictures, posters, soft toys and games in order to provide more stimulation for the residents in the home, especially those with dementia. We saw one resident holding a soft toy, which, it is understood, can help to provide comfort for someone who is confused. However appropriate signage is still needed to guide the more confused residents to their bedrooms and toilets to enable people to remain as independent as possible. The manager said that other activities have been planned and entertainers booked to come to the home for the benefit of the residents. The manager has confirmed that 3 senior members of staff at the home are booked on a 3 day specialist dementia training course starting 16th April. This is so that appropriate services can be provided for the people in the home with a dementia. The manager has confirmed in writing that all the immediate requirements, made after the last inspection of the home, regarding the administration of medication, have been implemented and that there is now a safe system for administering and storing medication and for training staff in this process. The manager has confirmed in writing that the immediate requirement made after the last inspection, that call alarms must be positioned within residents reach in their bedrooms or that it can be demonstrated in care planning that this is inappropriate, Care Homes for Older People
Page 4 of 19 has been complied with. What they could do better:
We arrived for the inspection at 5.45 am. The night care worker let us in and we told her to continue her normal routine. We saw two residents woken by the care worker between 6 and 7 am and taken from their bedrooms to the one bathroom used. One care worker was on night duty but she contacted another care worker from the staff accommodation, who, although she was not rostered to work, came and helped with the care of the second resident until the day staff arrived. We saw that both residents were very wet. Incontinence pads, knickers and beds were wet. We saw the two residents transferred, one using two care workers who used an underarm lift, onto a shower chair, and moved backwards with their feet dragging along the floor. The first resident who was wet up to their arm pits, was moved in their wet night dress. The resident had to go down in the lift alone on the shower chair as there was no room for the care worker in the lift which was otherwise full with a wheel chair and sit-on scales. Later we saw a third resident assisted from their bed and they and their bed and quilt were soaking wet. The night care worker we spoke with confirmed that the incontinence pads used did not keep residents dry through the night and that people were often found equally wet in the morning. Besides being very uncomfortable and undignified for residents, this means that some residents skin is put at risk and we told the manager that people must be reassessed and provided with appropriate incontinence pads and equipment. Before 7am we saw one resident left outside the ground floor bathroom in a wheel chair in a wet pad and night dress with nothing round her for dignity and she was distressed and trying to pull her night dress down. Once in the bathroom the door would not close easily as the bathroom was too small for the wheel chair and the care worker. When we were all in the room we saw an underarm lift used to transfer the resident on to the over bath seat. During the inspection we also saw one resident become increasingly distressed as they needed to go to the toilet and could only walk slowly using a zimmer frame. Once they arrived at the toilet designated for them to use they had to wait as the room was in use, although there was a toilet nearer to where they had been sitting. In the event they had to be taken to the toilet in the en-suite of a bedroom which was not being used at that time. It was not clear why the nearer toilet could not be used by this resident. We checked some care plans and saw that some updates had been recorded for the care provided. Details of two hourly turns had been recorded for a resident who had recently died in the home as had been required for their terminal care. However it was not clear how these turns had been achieved during the night when only one care worker is on duty. The care plan of another resident stipulated that their feet should be elevated when seated in a chair. We observed that a stool had been provided for this resident when they had arrived in the dining room and their feet were elevated during the inspection. We saw details in care plans showing when a district nurse had recently dressed a residents sacral pressure sore and showing that another pressure sore was now healed. Appropriate equipment had been provided in these instances. However the Commission had not been informed about these pressure sores as is required under Regulation 37 of the Care Standards Act. We have also been informed by reviewing officers from the Local Authority, since the inspection, that two named residents have developed pressure sores on their heels. The practice of transferring Care Homes for Older People Page 5 of 19 people on shower chairs or wheel chairs with their heels dragging on the floor must cease as there is a risk of skin damage to peoples heels when this takes place. We had seen one resident assisted out of bed by the night care worker and the care worker confirmed that normally this assistance was provided by one member of staff. We saw some bruising and red marks on both of the residents legs, below the knee but saw no details of this bruising noted on a body chart or described in the residents care plan. In the safe environment section of another plan, recorded as reviewed on 11/3/09, it stated ensure all things in the room are suitably laid out in order to allow full mobility In the mobility section it stated that 2 carers were required to help transfer and mobilise the resident. However we saw a recent letter from a physiotherapist on file which stated that the resident had been discharged as she was unable to mobilise and there was a health and safety risk. There was no management plan or risk assessment in the care plan to show how to manage the situation and during the inspection we saw three care staff involved in assisting this resident out of bed. On initially entering the bedroom we also saw that this resident had an arm chair positioned against the side of the bed while the resident was in bed. This could mean that the resident was being restrained or that the provision of bed rails should be considered. However there was no explanation of this chair in the care plan. Care plans must be continually reviewed an updated to ensure that care staff are clear about how individual needs are to be safely met so that neither the resident nor care staff are put at risk of harm. When we arrived at the home at 5.45 am we saw one resident up and dressed and walking down the stairs to the dining room. At 6.15 the care worker on duty knocked and entered a first floor room and switched on the light. The resident was still asleep but the care worker gently told them its time to get up. The resident had to be woken up and was clearly very sleepy and kept closing their eyes. The care worker told us that care staff have instructions from the manager that this resident has to be got up at 6am each day and that they sometimes cry and are more confused at that time as they want to go back to sleep. We noted that the residents bed was wet as they were assisted to get up. We observed a second resident woken up before 7am although they were fast asleep. The care worker contacted a second care worker to assist her with getting the resident up, although the second member of staff was not supposed to be on duty. It was clear that one person would not have been able to safely transfer the resident. We observed that the resident was wet up to their arm pits and the bed was also wet. We observed that, by the time the second resident was in the bathroom, the first resident who had been woken up was asleep in a chair in the lounge and was clearly still tired. The care worker said they had a list of names of people who had to get up before the morning staff shift started. This means that people living in the home are not choosing when they want to get up but are fitting in with the routines of the home and with the way staff are deployed. As at the last inspection we saw a supply of tablet soap, toiletries, shampoos and toothpaste in the cupboard under the stairs. The manager said that she still purchases these general supplies as some residents have no access to their personal allowances and are therefore not able to buy their own toiletries. We again advised the manager, as we had at the previous inspection, that all residents should have access to their allowance or have individual items purchased for them from their allowance and that where this was not the case a referral should be made to the Local Authority under joint agency safeguarding procedures. Care Homes for Older People Page 6 of 19 We noted that the television was switched on when we arrived at the home although we did not see anyone watching it. Some quiet music might have been preferable as people were sleeping in the lounge in those early hours. We went into the kitchen before the day staff arrived at the home and saw a plate which contained chicken nuggets and a slice of buttered bread. The care worker said this was part of the previous days residents tea although it was not as described on the menu. We watched the care worker throw the food away.We saw 8 bottles of orange juice and six litres of fresh milk in the fridge. The care worker said the next milk delivery would be in two days time.We noted that the milk was semi-skimmed and the manager later agreed to check with a dietitian whether the residents in the home would benefit from milk with a full cream content. We did not see any fruit displayed or offered to residents during the inspection and the only fruit we saw in the kitchen was one melon and one small bag of Clementines stored in a cupboard. Most breakfasts had been already prepared and we saw two dishes of cereal and two dishes of Weetabix and one plate containing three jam sandwiches covered and ready in the kitchen. At the last inspection the manager said she would offer residents choices of food at breakfast time and would set the tables with cereal and juice. The manager said that this had been tried without success. However one resident who sat near us during the visit was asked by staff would you like a sandwich for breakfast, rather than asking what they would like. The resident replied that they would like this with jam and some biscuits. We asked the resident if they preferred this for breakfast and the resident replied that they were not offered anything else but would eat cereal and would like egg and bacon, but this was not offered.The resident also said that the dinner and tea meals were OK but there is no choice. The food is already done. The resident said that they were sometimes hungry and no food was served after 5pm. The manager said that sandwiches were available for residents after 5pm when tea was finished. At 8am three residents were still in bed but had not been offered a cup of tea. The manager must ensure that records are kept to evidence what food is offered and eaten by residents as guidelines on nutrition for the elderly are clear that people should not go for more that 12 hours without food and drink. Residents must also be involved in choosing the food they eat and the manager should research current guidelines on providing meals for the elderly or seek advice from a dietician. We saw care workers take several residents into the bathroom during the inspection. We saw that there was one pair of thick coloured household type gloves in the bathroom and a care worker confirmed that this one pair was to be used by her when providing personal care for all but one of the residents. We saw this one pair repeatedly used and noted that no care workers used disposable gloves or aprons when providing personal care, although this is seen as essential equipment for promoting good infection control. During the visit we saw several members of staff removing wet bed linen from residents bedrooms and carry this soiled washing through the home, through the dining room while residents were eating, to the laundry. We saw all these members of staff carrying this washing next to their clothing without the use of any gloves or aprons. None of the soiled washing was bagged. The manager confirmed that staff are hand sluicing soiled linen as there are no sluicing facilities in the home or in the washing machine programme. We saw one care worker tuck a wet Kylie sheet under a hall table when she had to assist a resident while on her way to the laundry.We saw a small open bin containing a supermarket carrier bag, in the ground floor bathroom. As each resident was taken in to be bathed, the bin was filled with their wet pads and the bathroom and hallway smelled of urine. An Care Homes for Older People
Page 7 of 19 appropriate closed bin must be provided for soiled incontinence pads for infection control and for the dignity of residents. We noted that, at the beginning of the inspection, the under side of the toilet seat in this bathroom was soiled. This situation remained the same although a succession of residents used the seat. We saw a tablet of soap in the bathroom which the manager said only the staff used. Guidelines for good infection control stipulate that only liquid soap and paper towels should be used by all staff and residents to ensure infection is not spread in the home. This guidance was stressed at the last inspection and included in the last inspection report. We were therefore disappointed to see that there were no paper towels or soap in one bedroom where staff had handled soiled bedlinen and initially no paper towels in the laundry where staff took several loads of soiled washing. We saw one member of staff handle soiled bedding in the laundry and then walk straight into the kitchen without washing their hands. Another bedroom had a tablet of soap but no towel and one toilet had no towel or towel holder. We noted that, although the bath had been soiled during the personal care of one resident, the bath was not decontaminated between each residents use. It was apparent that the manager had not taken note of current guidance on infection control and had not obtained the current publications seen as essential for managers and staff in care homes. These publications were recommended during the last inspection visit. Providing staff with adequate supplies of disposable gloves and aprons is also considered as absolutely basic for ensuring infection is controlled in all care settings and it is totally unacceptable to provide care staff with one pair of household gloves each for providing personal care. We saw evidence that the manager was regularly testing the blood sugar levels of two residents who have diabetes. However, the manager was using equipment which is designed for self-use and should only be used for one person to ensure there is no cross infection. It was clear from what has already been noted that having only one member of staff on duty in the early hours of the morning is not sufficient. We saw at least one resident who needed two people for assistance to get up and we saw two people left alone on the bath seat, over the bath, when the one carer on duty had to perform another task. These practices put people at direct risk of harm. We noted that one resident had been left in bed, although awake for some time, until after 8am. This was because three people had to assist with the transfer. This resident was not given a cup of tea as the staff were busy with other residents and we saw that the resident and their bed were soaking wet when they did get up. Since the inspection we have learned from Local Authority reviewing officers that one quite heavy resident has been assessed as needing to be turned in bed every two hours. Clearly one care worker cannot manage this task alone. We also saw details in the care plan of a resident who had recently died that they needed to be turned every two hours. It was not clear how this requirement had been achieved for that resident. We therefore visited the home again on 30th April and made an immediate requirement that two members of staff must be on duty at night in the home from 30th April 2009. The manager has stated in writing that a named domestic worker had been recently employed at the home but had now left. However we saw no evidence of this recruitment and the manager confirmed that the required recruitment, including criminal records bureau checks, had not taken place. Recruitment checks are necessary for all staff who have access to vulnerable people and this failure could have put residents at risk of harm. During the inspection we observed care practice which directly put residents at risk of harm. We saw two residents moved through the home on a shower chair. The chair was dragged backwards with the residents feet dragging Care Homes for Older People
Page 8 of 19 on the floor, which could damage the skin on their heels over time. We also saw one resident moved backwards in a wheel chair with no foot plates used and their feet dragging. We had noted at a previous inspection that another resident was at times being moved on a shower chair. This resident now has a pressure sore on their heel. We saw care staff assist one resident to transfer using an under arm lift. This move is not recommended when moving people as it can cause damage to the person concerned. We saw one resident who was on a shower chair, taken into the lift and sent down in the lift alone. This was because the lift was being used to store a wheel chair and the new sit-on weighing scales and there was no room for the care worker. Residents should not be left alone in a lift as they could be put at risk of harm. As already noted we also saw residents left alone on the bath seat in the bathroom, which presents a serious risk of harm. We also saw two bedroom doors and the kitchen door wedged open during the inspection although we had made a requirement at the previous inspection that this must not happen as it compromises fire safety and the manager had confirmed in writing that this requirement was being complied with. We had been informed by the manager that a resident had recently gone missing from the home and had been found by police at a local hospital. However, when we checked the records we found that no risk assessment had been completed to consider the implications of this event although this assessment should have been in place and staff made aware of any control measures needed. The Commission has not been informed that some residents have developed pressure sores and this is required under regulation 37 of the Care Standards Act. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 9 of 19 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 7 15 The care for each resident must be regularly reviewed and documented in detail in their care plan. This is to ensure that all staff are aware of the current needs of the resident and aware of how these needs are to be met. 01/02/2009 2 7 15 18/05/2009 The service user or their representative must be consulted and involved in the written care plan whenever possible. This is to ensure that all parties are clear about the care to be provided. 3 7 15 All residents in the home must have a written plan which details all their needs and shows how these needs are to be met in a Person Centred way. This is so that all residents are supported by staff in a way that reflects their personal wishes and goals. 18/05/2009 4 10 12 All residents must be 01/01/2009 provided with their own toiletries and these, together with their own toiletries must
Page 10 of 19 Care Homes for Older People Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action be left in their own bedrooms. This is to ensure the dignity and privacy of residents is maintained. 5 12 16 A suitable range of activities must be provided for residents in the home on a daily basis. This is to ensure that adequate stimulation is provided. 6 14 12 01/02/2009 Efforts must be makde to provide residents with choices in their daily lives so that they can decide the time they get up and go to bed, choose what food to eat and have the option of going to their room in the day. This is to ensure that residents dignity, privacy and right to make choices is maintained. 7 15 17 Records must be kept of the actual food eaten by residents. This is to ensure that individual diets are satisfactory. 8 18 13 All staff at the home must complete up to date training in Adult Safeguarding and Whistle Blowing and must demonstrate their 18/05/2009 18/05/2009 18/05/2009 Care Homes for Older People Page 11 of 19 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action understanding of these topic. This is to ensure that people living at the home will be protected from harm and abuse. 9 26 13 All communal bathrooms and 01/01/2009 toilets must contain liquid soap, soft paper towels and toilet paper and individual bedrooms must contain appropriate soap, towels and toilet paper. This is to ensure that good infection control is maintained in the home. 10 29 19 A signed record must be kept 01/02/2009 in the home of the Terms and Conditions agreed with each member of staff including the hours they are employed and paid for each week and in what position they are employed. This is to ensure that staff are clear about their duties and responsibilities and can provide appropriate care for people in the home. 11 29 19 All staff must provide details 01/02/2009 of all employment histories and two appropriate written references must be obtained before new staff start work. This is to help protect residents from risk of abuse. 12 30 18 All staff in the home must be 18/05/2009 Care Homes for Older People Page 12 of 19 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action provided with assistance, including time off, for training. This training must be planned with staff. This is to ensure that staff have the necessary skills to meet the needs of residents. 13 31 10 The manager must 01/02/2009 undertake periodic training and must keep herself informed of current research and guidelines for the provision of care. This is to ensure that residents in the home receive the best support in meeting their needs. 14 31 13 18/05/2009 The manager must ensure that appropriate written policies and procedures are in place and that these are reviewed and kept up to date. Policies must be updated quickly for Safeguarding Adults, Whistle Blowing, Infection Control and the Administration of Medication. This is so that staff especially are aware of procedures to be followed for the benefit of all parties in the home, and to ensure the safety of residents. 15 33 24 A formal quality assurance 18/05/2009 system must be in operation at the home. Care Homes for Older People Page 13 of 19 Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action This is to ensure the views and wishes of the residents and their families are used to improve services at the home and to affect the running of the home. 16 38 23 Fire doors in the home must not be wedged open or closed. This is to ensure fire safety in the home. This was required to be met by 17.11.08. The proprietor has responded to this requirement and has confirmed compliance. 17 38 13 18/05/2009 The homes Health and Safety Policy and Statement must include appropriate general risk assessments for the use of two recliner chairs in the home. These must then be identifiedin the individual persons file with appropriate detail to ensure the people are kept safe. This is to protect residents from any unnecessary accidents. 17/11/2008 Care Homes for Older People Page 14 of 19 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action 1 13 38 Service users must be 08/04/2009 transferred safely at all times using a hoist where appropriate and they must not be transferred with their feet dragging on the floor or lifted by staff using an under arm lift. This is to protect service users and staff from the risk of harm. 2 13 38 Service users must not be left unsupervised in dangerous situations including being left alone on an over bath seat or left alone on a shower chair in the lift. This is to prevent the risk of harm to service users. 08/04/2009 3 13 38 Full moving and handling assessments must be completed and updated by appropriately trained staff, for all service users. Details in plans must show how any risks are to be managed. This is so that care staff are clear about moving plans and any associated risks to prevent the risk of injury to residents and care staff. 08/04/2009 4 26 13 Liquid soap and paper towels 08/04/2009 must be available in all communal bathrooms and toilets and in all rooms where staff wash their
Page 15 of 19 Care Homes for Older People Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action hands. This is so that good infection control is maintained in the home and so that service users and staff are not put at risk of harm. 5 26 13 Single use blood glucose 08/04/2009 monitoring systems must not be used for more than one service user. This is to comply with Department of Health guidelines to prevent the spread of infection which could put service users at risk of harm. 6 26 13 Appropriate disinfectant must 08/04/2009 be used to decontaminate the shared bath between uses. This is so that good infection control is maintained in the home and so that service users and staff are not put at risk of harm 7 26 13 Appropriate closed storage must be provided for used incontinence pads. This is so that good infection control is maintained in the home and so that service users and staff are not put at risk of harm. 8 26 13 Care staff must have access 08/04/2009 to adequate supplies of disposable gloves and aprons and must use these whenever appropriate.
Page 16 of 19 08/04/2009 Care Homes for Older People Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action This is so that good infection control is maintained in the home and so that service users and staff are not put at risk of harm. 9 26 13 Soiled laundry must be transported through the home in appropriate sealed bags. This is so that good infection control is maintained in the home and so that service users and staff are not put at risk of harm. 10 27 18 30/04/2009 There must be two appropriate staff members on duty at night in the home. This is to ensure that all the needs of service users can be safely and appropriately met. 11 27 18 Staff numbers and deployment must be immediately reviewed in the home. This is to ensure that service users are provided with adequate care at all times and not put at risk of harm. 12 29 19 08/04/2009 No individual must be allowed to work in the home until they have been appropriately recruited and until evidence of all essential employment checks are in place. This is to ensure that service users are protected from Care Homes for Older People
Page 17 of 19 08/04/2009 08/04/2009 Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action possible abuse by inappropriate care staff. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 8 13 Service users must have regular reviews of incontinence aids and must not be left in wet pads and wet beds all night. This is to ensure that service users are comfortable at all times and so that their skin integrity is maintained. 15/04/2009 2 10 12 Service users must not be transported through the home in wet night clothes with no cover around them. This is to ensure that service users are comfortable at all times and can maintain their dignity. 10/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 28 50 of care staff in the home should be trained to NVQ level 2 or above to ensure that the needs of service users can be met by a professional workforce. NVQ training should be made available to all staff in the home. Care Homes for Older People Page 18 of 19 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 19 of 19 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
