Inspection on 03/01/07 for Manchester Court

This inspection was carried out on 3rd January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Manchester Court 18/11/08

Manchester Court 07/11/07

Manchester Court 21/06/06

Manchester Court 17/03/06

Manchester Court 30/08/05

Manchester Court 14/03/05

Manchester Court 03/11/04

Manchester Court 26/03/04

Similar services:

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Fairfields Country Rest Home

Poldhu

Queensmount

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

CARE HOMES FOR OLDER PEOPLE Manchester Court 77 Clarence Street Cheltenham Glos GL50 3LB Lead Inspector Mr Tim Cotterell Key Unannounced Inspection 3rd January 2007 10:00 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 Manchester Court DS0000016498.V326193.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. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manchester Court Address 77 Clarence Street Cheltenham Glos GL50 3LB 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) 01242 523510 Raynsford Cheltenham Limited Mr Nicolas Allan-Yorke Care Home 20 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10), Old age, not falling within any of places other category (10) Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2006 Brief Description of the Service: Manchester Court is a listed building in the centre of Cheltenham. It is near to the town centre with all its amenities, and central library and museum are a hundred yards away. The Parish and Roman Catholic churches are near by. Accommodation is on four floors. The kitchen, laundry and some storage areas are in the basement. On the ground floor is the communal dining room and lounge. A shaft lift and stairs serve all residential floors. The bedrooms are located on all floors and are for single occupancy. There are no ensuite facilities, although washbasins are provided in each room. There is level access to the rear of the building, which opens onto a courtyard with some adjacent car parking spaces. The front door has three steps down and opens directly on to Clarence Street. The charges of the home are £270 per week and there are no additional charges. The home has a Statement of Purpose and a Service Users Guide and they provide the information which is required for new and existing service users The home will ensure that service users are kept up to date by providing them with the most recent inspection report. There is a notice board in the home and minutes of the service users meetings are available. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The inspection was undertaken by two inspectors and included talking to the registered manager, all care staff on duty and the service users who wanted and were able to offer comment. Seven service user, one relative and four staff surveys were returned to the Commission. The contents of the surveys were complimentary about the home. A number of records were inspected and they included medication, plans of care, personal monies and risk assessments. There was a relaxed atmosphere in the home and it was evident that service users were able to follow individual lifestyles and were able to exercise choice over how they spent their days. Further improvement have been made to the physical environment and a number of the bedrooms had, with the assistance of staff, been personalised What the service does well: Staff offer information and support and this enables service users to make informed choices about how they should spend their time. There is a good relationship between staff and service users and the service users meetings offer an opportunity to comment on and influence practices in the home. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Standard 6 not applicable. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users are assessed and are able to visit the home before admission to ensure their needs can be planned for and subsequently met. Verbal assessments are received from supporting healthcare professional when required and should be recorded for reference. EVIDENCE: The registered manager stated that all service users were assessed before admission. A new service user spoken to about admission to the home agreed with this and said he had also visited the home before and was given verbal information about the home, but no Service User Guide. The registered manager agreed to provide the service user with the guide. The service user said he was made very welcome and felt the care staff respected him but was finding it difficult to adjust. The staff were aware of the new service user’s anxiety and attempts to reassure him were observed. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 9 The pre-admission assessments were seen for new service users. The records were good but there were some omissions, to include dental health and the history of falls. Standard three of the National Minimum Standards for Older People outlines all the areas to be addressed before admission and it was recommended that the manager uses this for guidance. There was no evidence of a social services assessment or healthcare professional assessment prior to the admission of the last three service users. No contract was seen with social services or terms and conditions with the home. Verbal advice and information received from healthcare professionals prior to admission should be recorded. Some service users have mental health needs which should be identified and clear care plans provided to help support them and provide continuity of care. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plan recording has improved, but additional recording will help improve outcomes for service users. Medication systems have improved and audits are completed to maintain safe practice. Some omissions found in recording may put service users at risk. Service users spoken to felt they were treated with dignity and respect. EVIDENCE: Four care plans were looked at and the format used was generally good. The methods used needs to ensure that all plans are consistent. Care staff need to continue to develop detailed actions for each problem, in particular, challenging behaviours, and address diversity issues. Care plan reviews are monthly but must be more meaningful and not just signed. The reviews should be an overview of what has been recorded in the Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 11 daily records during the month and any progress or changes identified after consultation with the service user, and or advocate/relative. Daily records were improved with significant events and daily progress recorded. Individual risk assessments had been recorded, should a risk be identified then a care plan to reduce the risk is required. Service users’ weight is recorded monthly, or weekly should there be any concerns. Two service users do give cause for concern as they eat very little. A nutritional assessment should be recorded to identify eating patterns, intervention required and progress, including when to involve professional support. The records of healthcare professional visits were more prominent in the records. It was recommended that nighttime care is more easily identified, and an initial page could list all care plans for easy access by the care staff. One service user who had double continence care needs had no plan for checking during the night and could be asleep for 11-12 hours in a soiled pad. Service users who are restless at night should have a care plan to record actions for staff on their mental health care plan or their sleeping plan. Care staff observed with service users had communication skills that helped to reassure and alleviate anxieties. However, there may be a need for more individual attention for some service users, as care staff remain very busy with twenty service users who have diverse mental health needs. The registered manager had a good rapport with the service users and an open door policy with staff and visitors was observed. The registered manager stated that the Continence Adviser visits the home as required. A service user who manages his own continence needs was progressing well and staff monitored compliance. The service user was spoken to and appeared less anxious and generally looked well cared for. The registered manager stated there were no service users with serious physical heath needs, however, there were concerns regarding suicidal tendencies for a service user. This service user was spoken to and was relaxed and communicative and still enjoyed helping in the home and had freedom to leave the home. There is a need to complete detailed social histories and identify areas of need regarding purposeful activities for service users, and any mental health care issues. Accidents records were seen, it was recommended that an audit be completed every few months to identify any patterns for prevention and action to be taken. Then the record can be filed with the individual service users care plan. The registered manager stated that he audits the care records when the Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 12 keyworkers have supervision sessions with him. Recently the recording of meaningful reviews had been an issue and there was evidence of an improvement in two care plans. The provider requested some information about Regulation 37 notifications and this was emailed to him after the inspection. The registered manager must ensure that Regulation 37 notices are sent to the Commission, as a service user who was admitted to hospital in a coma and subsequently died had not been reported. Information regarding this procedure was emailed to the registered manager. It was recommended that the manager look at the Commission’s web site at www.csci.org.uk. The care records are in individual folders now stored in a new locked cupboard that is easily accessible to care staff. The home has a new improved medication storage area, which is secure and spacious. There was no medication currently stored in the fridge. Medication is transferred to a trolley for morning and evening administration and taken to the service users. A medication administration round was observed at lunchtime and care staff used a small metal box to transport medication as only 4 service users required medication. A recorded fortnightly medication audit, completed by the registered manager for four service users, was seen. It was recommended that more than four are audited to ensure a complete monthly audit for twenty. The inspector completed a random audit (tablet count) of two administrations and one was incorrect. Care staff must ensure that when one or two tablets may be required the record must clearly indicate how many. An audit of refused medication was correct and disposals were handled and recorded correctly. Boxes of medication were not dated but the procedure was to start a new box each month regardless of any remaining. It is recommended that the start date is recorded on containers not included in the monitored dosage system. None of the service users were self-medicating. Administration records were incomplete, as the allergy record was blank and cream applied for a service user had not been recorded. Transcribed handwritten medication records were not signed. There was good evidence that some ‘as required’ medication had a care plan to identify usage, however, there was one omission. Any errors in medication administration were indicated to the registered manager at the inspection to be rectified as soon as possible. The medication policy and procedure was seen and was due for review in May 2007, the home also has a copy of the Royal Pharmaceutical Society’s medication guidance. There was an appropriate medication reference book. The home has a controlled drug book not currently in use. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 13 The registered manager stated that he monitors staff administration by observation and should an audit reveal a concern then staff are supervised to ensure proficiency is maintained. There was evidence of care staff receiving medication training in 2002 and monitored dosage administration training by the local pharmacist in 2004. The registered manager plans to update medication training for all staff this year. There has been a stable staff group at the home for many years. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home attempts to meet the diverse needs of the service users and provide a flexible and caring service by providing support, independence and choice. Service users like the food provided and there is flexibility for the provision of alternative meals. EVIDENCE: A number of the services users are able to access the church and shops independently. One service user told the inspector that he attended the local college and was supported by staff. The home has a programme of activities and it is appreciated that such diverse needs will present a challenge when attempting to meet individual needs. There is little doubt that staff continue to make efforts to provide some daily stimulation through activities, and on the day of the inspection a significant number of service users were enjoying a music afternoon. It is important that Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 15 during the activity periods there are sufficient staff on duty to ensure the activities and personal care needs are met. Service users are able to exercise choice about when they get up and when they go to bed. On the day of the inspection a number of service users were able to stay in bed, as was their normal pattern The home encourages and welcomes visitors and everyone has the ability to see their friend’s/relatives in private. A number of friends were visiting at the time of the inspection and felt that the home welcomed them. The inspector visited the kitchen when lunch was being prepared and was pleased to note that a number of alternatives were being prepared, as some of the service users did not wish to have the main meal. The kitchen was clean and well organised although it was felt that the windows and surrounding areas need cleaning. It is appreciated that the road traffic and associated difficulties are a major contributor to this problem. The minutes of the last service users meeting included a request for a specific meal to be included on the menu and this had now been done. A service user who looked thin was having regular complimentary food drinks in his preferred flavours from the pharmacy. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are competent to ensure service users have their rights assured and are protected from abuse. EVIDENCE: The home encourages friends and relatives to visit and staff and management are always available if they are needed. The majority of service users would have difficulty in making a formal complaint, however there is a monthly meeting where matters of interests are raised, and wherever possible solutions found at this informal level. The positive relationship staff have with service users has meant that most matters are dealt with quickly and informally. Staff have now had further training in the prevention of abuse and were aware of the rights of the service users and the responsibilities of staff. The inspector was advised that one service user has presented challenging behaviours and that this may require a response, which would be seen as “physical intervention”. A protocol for any planned and unplanned intervention must be compiled on a multi-disciplinary basis to ensure staff respond Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 17 appropriately, and that the rights and dignity of the service user and staff are protected. It is essential that staff are updated in respect of adult protection issues to include the procedure for recording and reporting any allegations of abuse. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has made a number of improvements and now provides a more comfortable and pleasant environment. EVIDENCE: All of the accommodation, to include dining and lounge areas, bathrooms and toilets, and a number of bedrooms were seen. Considerable work had been completed since the last inspection this includes new non-slip flooring in a number of bathrooms/toilets. The lounge on the first floor now provides a pleasant area due to decoration and replacement of some furniture. All of the required work made at the last inspection had been completed and the outside access to the lower ground floor had been made safer. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 19 Many of the bedrooms have been personalised and in all areas the home was found to be clean and odour free. Service users raised the issue of their inability to control the temperature in the lounge on the ground floor. The registered manager thought that the temperature could be controlled, however it was not possible to locate the thermostat easily due to the radiator cover. It is appreciated that staff may have many demands about temperatures in a communal room, and it is suggested that the matter is raised at a service users meeting in an attempt to find a compromise. The dining room carpet is stained and needs cleaning. Bedroom 19 - the window (lower casement) needs attention, as it will not stay open. Would you please ensure the outside windows are kept clean. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff were seen as competent, caring and responsive to individual needs. Further staff training had been provided. The question of the need for dedicated ancillary staff must be constantly reviewed. EVIDENCE: The home has not made any new appointments since the last inspection, in the circumstances staff recruitment records were not inspected The home is staffed by four carers and the registered manager up to 1400 then three carers until 1800. The inspector was informed that between 1800 and 2100 there are two carers on duty. In view of the dependency levels of a number of service users this cover must be reviewed to ensure there are sufficient staff during this critical period. The night staff take over at 2100 and they consist of a waking and sleeping carer. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 21 The registered manager holds monthly staff meetings and also sees the key workers individually at the same frequency. Staff have recently undertaken training in the identification of abuse and this included staff on night duties. Staff on duty were seen as competent and sensitive to individual needs. The cleaning of the home continues to be undertaken by “care staff” who have defined time in their shift to undertake cleaning duties. It is a requirement that the home provides enough care staff to meet the needs of the service users at all times. The needs of the group may change over time and the recent admissions must be carefully assessed to ensure this is being done. The home accommodates very vulnerable service users who may not be always able to express their needs; therefore the home must undertake a continual review of staffing resources. Whilst there is no evidence of any failure on the part of the home to meet needs we will continue to encourage you to have separate ancillary staff to undertake the cleaning duties The home now employs a handyperson and there is a record of all the work required, which has resulted in minor works being completed without delay Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed in a friendly open manner and the registered manager was seen as a good listener and approachable. The personal monies records seen were incorrect and the manager will personally audit to ensure compliance. The home sends out annual questionnaires to quality assess the service. EVIDENCE: Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 23 The registered manager continues to make great efforts to meet the current requirements. Improvements have been seen in a number of areas and it was evident that the manager and staff are anxious to provided a good service, which meets the individual needs of the service users. The registered manger is now acting as the responsible individual for the company. Visits to the home under Regulation 26 are not being required, as the registered manager is in the home and on duty each weekday. There is an equality and diversity policy and the registered manager is aware of the new legislation and the implications for care homes. There is an annual questionnaire produced by the home and sent to health professional, visitors and relatives and the results are collated and are available to any interested parties. A number of personal monies records were seen. Two of the records were found to have the incorrect records but the manager was able to find the error in one, and with staff will audit the other. It is essential that detailed records of monies received, held and managed on behalf of service users are correct and subject to continual audit. Three new admissions had been made since the last inspection and the registered manager confirmed that not all of them had a classified “mental disorder”. The home is registered to accommodate adults who are suffering from mental disorder, excluding dementia and learning disability, or older persons who do not fall in any specific category. If it is the intention to admit further service users who do not fall in either registered category then clearly the question of how appropriate such admissions are must be discussed. Until this happens all admissions must fall within the existing categorises for which the home is registered. Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement All care plans to be completed to include meaningful reviews and the following; • A care plans for any risks identified. • Identify night care needs and provide clear actions. • Identify mental health needs and provide clear care actions to support and maintain continuity of care for service users. • Complete nutritional assessments and appropriate care plans for action to be taken. • Complete social histories to include any mental health care needs. Medicine administration methods must be safe and follow the guidance from the Royal Pharmaceutical Society; as follows; • Record the amount of tablets given when one or two are prescribed and include in the care plan the reasons for different DS0000016498.V326193.R01.S.doc Timescale for action 01/03/07 2. OP9 13 01/03/07 Manchester Court Version 5.2 Page 26 • • • • • dosage. Complete the allergy record. Ensure all ‘as required’ medication have a written protocol. (Previously required) Sign all transcribed handwritten medication records. Sign when creams have been applied. Record start date on all medication containers not on MDS system. 01/03/07 3 OP15 23 The registered manager must ensure that the kitchen window areas are clean. 4 OP18 13.6 The registered manager must 01/03/07 provide a written protocol for managing challenging behaviours in consultation with the multidisciplinary team and ensure staff are able to implement the procedure. The registered manager must ensure that the window and carpet mentioned in the report has attention. The registered manager must ensure service users are able to control temperatures in the ground floor lounge. The registered manager must ensure that staffing levels are reviewed between 18.00-21.00 hours and for staff cleaning duties and undertaking activities with the service users. 01/03/07 5 OP19 23 6 OP25 23 01/03/07 7. OP27 18 01/03/07 Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 27 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 Refer to Standard OP3 OP3 OP7 OP9 OP18 Good Practice Recommendations The registered manager should ensure that the preadmission assessment contains all relevant healthcare needs using NMS 3 for guidance. The registered manager should record healthcare and social care pre-admission assessments and keep a copy of individual service user contracts and term and conditions. The registered manager should complete regular audits of any accidents in the home. The registered manager should complete medication audits more frequently. The registered manager should update care staff on the procedure for recording/reporting allegations of abuse (whistle blowing). Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Manchester Court DS0000016498.V326193.R01.S.doc Version 5.2 Page 29 - 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!