CARE HOMES FOR OLDER PEOPLE
Lynwood Lynwood 57 Mersey Road Heaton Mersey Stockport Cheshire SK4 3DJ Lead Inspector
Sylvia Brown Unannounced Inspection 19th October 2006 08:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Lynwood DS0000008603.V314806.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. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Lynwood Address Lynwood 57 Mersey Road Heaton Mersey Stockport Cheshire SK4 3DJ 0161 432 7590 0161 613 0633 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. Mohsin Munif Mrs. Anne Munif Mrs. Anne Munif Care Home 23 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (20) Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 20 OP, up to 10 DE(E) and up to 3 MD (E). 26th May 2006 Date of last inspection Brief Description of the Service: Lynwood is a large Victorian detached house which has been converted into a care home and is set in its own extensive grounds. The accommodation consists of 21 single rooms and one shared room, which are spread over three floors. Three of the single rooms and the one shared room have en-suite facilities. There is one large dining room, which has a small seating area overlooking the garden, two further lounges and a conservatory. The home is owned by Mr and Mrs Munif and is managed on a day-to-day basis by one of the registered providers, Mrs Munif. Lynwood is registered to care for 23 older people. The registration also allows for up to ten service users who are suffering from a dementia type illness and three service users who may have a mental health problem. The home is located in the Heaton Mersey area of Stockport and is close to local shops and other amenities. Stockport town centre, motorway network and public transport are easily accessible. The fee structure at the home ranges from £326 to £385. There were no topup fees applied at the time of writing the report. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection site visit to Lynwood was unannounced and completed in one day. The site visit was conducted as part of the overall inspection process of the home and concentrated on all the key standards and looked at the home’s progress towards complying with the requirements made at the previous inspection. Time was spent with service users observing their day to day routines and looking at the care support provided by staff within the home. Two care files were specifically looked at, as was the care of the individuals. Service users, their families and the staff team were provided with comment cards to enable them to inform the CSCI of their opinion of the service. At the time of writing the report, no comment cards had been returned. Comments received after the report is written will be included within the next inspection report. Various health and safety records were looked at, as were other records concerning the running of the home. What the service does well: What has improved since the last inspection?
Since the last inspection the home has worked towards improving its care practices and administration procedures. Staff appeared more courteous to service users and administration systems have developed which enables management systems to be evaluated more precisely. The deployment of staff has improved, with staff now taking separate breaks which ensures they are constantly available to respond to the needs of service users in a timely manner. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 6 The home has provided written information to confirm that the home has complied with all the requirements and recommendations of the fire safety inspection completed in March 2006. Accidents are recorded and action has been taken to ensure the records are held on some of the service users’ files. The recording of complaints is a little more detailed. On only one occasion was there a failure to record what action had been taken to resolve a complaint. Staff receive ongoing training, however accurate training and development records have yet to be developed sufficiently to identify all training planned for and completed. Redecoration has been undertaken in some parts of the home and new furniture provided in some bedrooms. The home has now increased the hours of one carer to specifically develop social activities for service users. Though, currently, activities are limited to two or three similar events, the carer stated it is her intention to seek advice and guidance from other people as to what can be provided and achieved and is considering a number of activities which should be suitable to meet the service users’ needs. The recording of visitors to the home is improving, with a record for signing being placed near the entrance and daily communications recording separately professional visitors entering the home. Though it was observed that the professional visitors’ record and service users’ files were not up to date regarding who had visited. Staff providing care support to individuals now write up the report of their actions themselves. This ensures that staff takes responsibility for their actions and confirmation about support is obtained, rather than assumptions made about support provision. What they could do better:
Over the past year, Lynwood has significantly developed its administration systems for recording information regarding the care of service users and the general running of the home. However, there continues to be further development needed to ensure that information is sufficiently detailed to reflect practice and care support provided. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 7 The home has extensive assessment and care planning records held on service users’ files. These could be reduced to enable a more concise recording system which precisely details the consultation process and outcome with service users about their care needs and how they should be individually met. Assessments should be more detailed to include what the issues are and how the home wants staff to support the service users in an attempt to reduce further risk. Daily records failed to detail personal details, such as rising and retiring routines, and service users’ actions and/or achievements throughout the day. Medication records were not completed appropriately with signature omissions evident and required medication not being on the premises as required. Two meal times were observed. Breakfast routines were leisurely, enabling service users to eat at their own pace and enjoy each other’s company, however the lunchtime meal was observed to be served in a rush, not allowing service users to finish one course before the next was served. It is recommended that the home consults with all service users and their representatives regarding this matter, to find out what they would collectively and individually like to have. Care staff may also have reasonable ideas and be able to support the home’s activities programme. Some service users commented that their rooms were not warm and that their radiators were not all working correctly. Prior to the inspection a main water tank had burst and although repairs had been swift, there was some impact on service users for a number of hours. The inspector has recommended that the heating system be looked at as the burst water tank may well have affected the heating systems. Recruitment and selection procedures continue to fail to meet the required standard and ill feeling between members of the staff team remains evident, with one staff being heard by a visitor making racist comments and using foul language. 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. Lynwood DS0000008603.V314806.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 Lynwood DS0000008603.V314806.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): 2 & 3. Standard 6 is not applicable to the home. Quality in this outcome area adequate. Service users have their needs assessed prior to moving in. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Of the two files looked at both had contracts in place. Evaluation of two care files identified that the home continues to complete preassessment and visits. The assessments looked at were as detailed as previously identified at inspection. The details were minimal and though they covered all the basic elements, more information is required to ensure the home can accurately assess if the home can meet the needs of the service user. Comments such as ‘poor mobility’, ‘risk of falls’ do not identify the level of ability or support required. The home does not currently inform the service user in writing that it can meet their assessed needs as identified. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 10 The home also receives pre-assessments from placing authorities, however they are equally as basic as the home’s. Lynwood DS0000008603.V314806.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): 7, 8, 9 & 10 Quality in this outcome area is adequate. Service users had their health care needs met, however records regarding their care need developing to identify the care support required and frequency. Medication records compromised service users’ safety, in that, they were not maintained appropriately. Service users’ dignity and privacy were compromised by the layout of the toileting facilities. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Care files contained a lot of information, however there was no definitive care plan which stated the service users’ care needs and how they should be individually met. Notwithstanding that, service users were observed to be well cared for and supported. Staff, when spoken to, were knowledgeable about the service users’ needs and were observed to be supporting them as they individually required. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 12 Various other aspects of service users’ care, such as doctors, district nurse and chiropody visits were recorded collectively in staff’s communication records, rather than on the service users’ individual files. Medication administration was observed and found to be appropriate. Time was spent with service users enabling them to take their medication at their own pace and be supported when difficulties arose. It was unclear if all service users received drinks of water from their own glass or if a collective glass was used at the first administration. The second administration identified better practice. It is important that all service users have their own glass of water when taking medication. Medication administration records identified signature omissions and the absence of required medication on the premises. Codes were not always identifiable and became confusing regarding what they represented. Staff practice appeared to have improved, in that, all staff observed spoke to service users in a dignified and respectful manner. The collective toileting of service users has reduced, although there was still some indication that this practice continues in smaller numbers. The toileting area in the main corridor is not suitable for the use of service users who require additional support or space. On a number of occasions, service users were observed to be independently using the toilets with the doors open due to their lack of space. One service user was seen trying to prevent another from being seen whilst using the toilet. The registered manager, who also observed this practice, stated that she was aware that they now needed adapting to make them suitable for all service users. Such facilities seriously reduce service users’ dignity and compromise their privacy. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Quality in this outcome area is adequate. Service users receive some social activities and are able to make some decisions for themselves. Service users receive a good diet from a menu which offers choice and variety. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Since the last inspection, the home has introduced an activities programme, however the activities are limited and repetitious. The new activities coordinator stated it is her intention to develop the programme and she has been provided with a budget. She also stated that the registered manager is seeking advice from other homes regarding how activities are undertaken. There was no indication that service users had been asked collectively or individually what they would like to do or see happening within the home or their views sought on the overall general service provision. Service users or relatives meetings are not currently held at the home. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 14 It appeared that service users, in the main, are able to choose when they rise and retire, and where they spend their day. Some service users prefer to remain within communal areas, whilst others choose to spend time in their bedroom. There are no restrictions on visiting. Most service users have visitors who take an active interest in their lives. During the inspection two meal times were observed. Breakfasts are relaxed, with service users receiving their food as they individually arrive to the table. Lunchtimes were more task orientated, with all service users being served collectively. Staff were observed serving the main meal to service users before they had finished their soup. They were heard saying “shall I take that (soup) or else your meal will go cold”. One gentleman, who refused to have his soup removed, had his main meal left on the table. The sweet and sour meal was observed to be eaten cold by the service user some 30 minutes later. There was no attempt to delay the serving of the main meal or ensure that it was kept warm or reheated when desired. One to one support was provided to those who required assistance. Staff were observed to be taking their time and talking to service users as they ate. Service users are offered a good diet and the menu is varied. Service users chose to have second helpings and stated they enjoyed the food very much. One service user, who was vegetarian, stated she was given alternatives when meat dishes were served. Of those spoken with, all stated they were generally satisfied with the food served. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 19 Quality in this outcome area is adequate. Service users are protected from abuse and know how to make their complaints known to the home. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home’s complaint procedures are known to service users and relatives and have been used when required. Complaints recorded identified relatives and service users had made complaints and that the home had taken appropriate action to investigate the concerns. Adult protection procedures are in place and staff have received training. There have been no allegations of abuse since the previous inspection. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23, 24, 25 & 26 Quality in this outcome area is adequate. Service users live in surroundings that offer comfort but require upgrading. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home has continued to redecorate and upgrade some areas since the last inspection. A substantial amount of investment is required to ensure all parts of the home meet the required standard. Unfortunately, the registered owners have stated that such financial investment is not currently available, therefore progress is slow. Notwithstanding that, some service users’ rooms have been redecorated and re-painting of woodwork has been undertaken. Service users’ rooms were personal in layout and appeared to have furniture which offered them comfort. Service users have been encouraged to take in personal items from their own homes and furnish their rooms as they wish.
Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 17 One bedroom had one curtain hanging at the window, with the other being found by a set of drawers. Curtains were either inappropriately hanging in the dining room or were absent from windows which had faulty curtain rails. Some bedrooms had odours, as did one lounge. The home has, over the past year, replaced a number of carpets within the home. The registered manager stated that odours were becoming an increasing issue, even though cleaning routines were in place odours remained. Communal areas vary in their standards, in that, some are functional whilst other areas are more welcoming. Lighting is adequate, though the use of low wattage or long life bulbs does not enhance the homely environment. One relative stated that she often found the corridors dark and had to turn lights on. On the day of the inspection the inspector had to switch lights on in the main corridor to ensure sufficient light was available. Bathing and toileting areas are functional, they are not personalised to make them homely. The toilets in the main corridor are not suitable for the use of service users and seriously compromise their dignity and afford them no privacy. This issue has been brought to the attention of the owners at a previous inspection after similar observations had been made by both visitors to the home and the inspector. Please see standards 7-11 Health and Personal Care for further details. Staff have to assist some service users some considerable way to toilets which are more suitable to meet their needs. It appears that, due to the placement of those toilets, staff collectively take service users to them. Whilst this practice was not observed to be as obvious as at other inspections, it was observed to still be in place. The registered owners have again been recommended to provide the CSCI with an up to date record of the home’s annual maintenance and investment plan for the home. They have been required to provide suitable toilets for service users. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. Service users receive support from staff who are trained and in sufficient numbers to meet their needs. The home does not consistently follow robust recruitment procedures which may place vulnerable service users at increased risk. Staff do not respect racial equality and have not formed positive working relationships. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Copies of the home’s rota were provided and analysed. Staffing levels appear adequate to meet the needs of the service users, however the rota does not routinely record the hours of the registered owner/manager or her assistant manager who attends the home and undertakes some duties. To support the staff team the homes also provides ancillary staff who provide the cooking, laundry and domestic services within the home. There was evidence that staff are better managed and receive more direction from the management team. Care practices are improving and staff now have separate breaks ensuring that service users are not left unattended. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 19 Practice observed was improved. Moving and handling techniques were correct, as was general assistance and support. Training records indicate staff are appropriately trained and continue with mandatory and other training. There has only been one new person recruited since the last inspection. Inspection of the staff member’s file identified that recruitment procedures had not been followed as required. The application form was basic and poorly completed, full employment history was absent and references not provided. There was no evidence to support how the person was consulted or had gained permission to work in this country. CRB checks had not been completed. A second staff file, observed at a previous inspection, continued to be without letters of appointment and contained information about undertaking and completing induction procedures. The home has yet to develop a formal process for recording interview procedures. The staff team continue with their training, with a high percentage of staff completing NVQ training at level 3. The staff group is made up of a number of overseas care workers who have been recruited to work within Britain’s care industry. A number of them are qualified within their country of origin to work within the nursing field. The staffing group as a whole have difficulties in relating to each other and working in harmony together. Following the inspection, one relative’s comment card was received which stated that although the care and food provision are good, the language of some white staff is disgraceful, stating that at her last visit she heard ‘disgusting and racist’ talk by the staff member. This behaviour is of concern to the CSCI and racist practice and/or behaviour against any persons must not be condoned or permitted at the home. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. The home is managed by an experienced registered manager who is developing a management team and systems to ensure its effective running for the benefit of service users. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The registered manager was on duty during the inspection; she made herself available and supported the inspection process. The registered manager has commenced training at NVQ level 4 and will proceed to obtain the Registered Manager’s Award. The registered manager gave open and honest responses to questions identifying for herself where the home requires development and the difficulties she has in achieving what is required.
Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 21 Practice has continued to improve, albeit slowly, and the home is now run more in the interest of service users than staff. Service users do not have the opportunity to share their views, nor do relatives. There is no quality assurance completed at the home and, as stated previously, there are no service user meetings. The home does not manage any monies for service users. As previous inspections have identified, service users and/or relatives are billed each month for all expenditures undertaken on their behalf. Health and safety records were looked at and were found, in the main, to be correct. The home’s fire safety records were completed at the required frequency. Accident records were in place, however analysis on service users’ files was not completed. Though some service users’ files contained the accident report, most did not. Servicing records for lifts and hoisting equipment were up to date and workplace risk assessments had been completed and signed by the fire safety officer. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 x 2 x 3 2 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X X 3 Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13(2) 17(1)(a) Requirement The registered person must ensure that medication administration records are maintained as required and that prescribed medication is on the premises. The registered person must ensure that toilet facilities on the ground floor, near the living rooms, are suitably adapted to ensure they meet the needs of service users and maintain privacy. The registered person must ensure that robust recruitment and selection procedures are in place and followed. (Timescale of 01/04/06 not met). The registered person must ensure all staff maintain good personal and professional relationships with each other. Timescale for action 21/10/06 2 OP10 12 & 23 02/04/07 3 OP29 19 & Schedule 2 12 01/11/06 4 OP30 15/12/07 Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 8 Refer to Standard OP3 OP7 OP7 OP15 OP19 OP26 OP27 OP29 Good Practice Recommendations The registered person should ensure that all preassessments contain in detail the identified needs of each service user. The registered person should ensure that a care plan is in place for all service users which clearly details the individual need for support and how it should be provided. The registered person should ensure that all professional health care visitors and support services are detailed within the service user’s individual file. The registered person should ensure that service users receive their meals at the appropriate temperature and when they wish. The registered person should submit, after assessment, the home’s annual plan for maintenance and investment. The registered provider should eliminate prevailing odours within the home. The registered person should ensure the rota details all levels of staff supporting the home, including the registered manager and assistant manager. The registered person should ensure that the home can evidence equal opportunities recruitment. Interviewing procedures and action should be recorded and letters of appointment on file for all successful candidates. The registered person should ensure that induction training meets the standards set by Skills for Care and recorded information can confirm when training was undertaken and for how long. The registered manager should complete training at NVQ level 4 and achieve the registered manager’s award. The registered person should provide service users with the opportunity to routinely comment, either collectively or individually, on the services offered at the home. The registered person should ensure that systems are in place to eliminate racist remarks and practice and that staff are protected from racist abuse. 9 OP30 10 11 12 OP31 OP33 OP32 Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 13 14 15 Refer to Standard OP30 OP33 OP38 Good Practice Recommendations The registered person should provide training in equality and diversity and race relations. The registered person should complete quality assurance procedures in accordance with Regulation 24. The registered person should ensure all accidents are recorded and detailed information retained on the service users’ individual files. Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Lynwood DS0000008603.V314806.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!
