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Inspection on 16/11/06 for Markfield Court Care Centre

Also see our care home review for Markfield Court Care Centre for more information

This inspection was carried out on 16th November 2006.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There are a range of activities provided by the home, arranged by the activities co-ordinator, such as carpet bowls, board games and bingo. Relatives can join in on some of the activities, and spend time with their relatives in care. On the afternoon of the inspection there was a trip out to the local garden centre. In the morning the bar was open where residents and relatives were sitting together enjoying a relaxing drink. Residents are fully supported in maintaining spiritual needs, regular church services are held in the home. There are excellent meal choices provided everyday. A range of meat, fish and vegetable dishes are offered and specialised diets are well catered for. There are good organisational systems in place for monitoring and reviewing the quality of service. Questionnaires are sent out to relatives and this information is returned to head office. Relatives spoken with reported that they are happy with this arrangement because they feel more comfortable to tell the truth. Staff were observed interacting with residents in a respectable and meaningful manner.

What has improved since the last inspection?

Records are held securely in the offices on each floor. This is important for safeguarding residents right to privacy and confidentiality.

What the care home could do better:

Although there was evidence found to indicate that contracts have gone out to relatives, neither relatives nor residents spoken with could remember seeing or signing such a document. This is an important part of the admission process and support should be given in this so that people understand their rights and know what to expect. Ensuring residents needs are assessed before they move to home could be done better, to ensure that the home is suitable and so that care plans can be developed. Residents and relatives should be involved in writing and updating care plans because this information is all about how residents want their care to be given. To promote good skin care, re-positioning and turning charts should be used for all residents that have or are at risk of getting pressure sores. Medication practice needs to improve to ensure the safety of residents. Not all complaints are being followed up using the complaints procedure, which does not ensure that expressed concerns are taken seriously and acted on. All complaints should be welcomed as a way to improve the service. Further progress in getting the staff team qualified is required, as this will ultimately benefit and improve outcomes for residents. Staffing levels at the home are inconsistent, depending on when staff are on annual leave and sickness. Staffing levels can fluctuate but this must be reflective of resident numbers and their level of need. Dependency levels of residents must be assessed to ensure that staffing levels are appropriate. Staffing levels is contributing to the low morale of the staff team. All staff, relatives and residents consistently made remarks about the manager`s approach. Evidence during the inspection indicates that the staff team are being inappropriately managed.

CARE HOMES FOR OLDER PEOPLE Markfield Court Care Centre Ratby Lane Markfield Leicestershire LE67 9RN Lead Inspector Joanna Carrington Key Unannounced Inspection 16th November 2006 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 Markfield Court Care Centre DS0000001917.V319447.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. Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Markfield Court Care Centre Address Ratby Lane Markfield Leicestershire LE67 9RN 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) 01530 242595 01530 244287 Ashbourne Life Ltd Mrs Caroline Doman Care Home 85 Category(ies) of Old age, not falling within any other category registration, with number (85), Physical disability over 65 years of age of places (85) Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Markfield Court Care Home is registered to provide personal care to male and female service users who fall within the following categories:Old age, not falling within any other cateogry (OP) 85 Physical Disability - over the age of 65 years (PD(E)) 85 To accommodate the person in the category DE(E) named in variation no. 48891 To accommodate the person in the category DE(E) named in variation number V34893. The maximum number of persons to be accommodated at Markfield Court is 85. 29th September 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Markfield Court is a care centre with provision for nursing and personal care. It is registered to accommodate up to eighty-five residents falling within Older Persons (OP) or Physical Disability (PD) Category over 65 years of age. The home is a traditional building which was formerly the nurses’ accommodation for the old Markfield hospital. It is located close to Junction 22 of the M1 on the outskirts of Ratby and Markfield, and is close to the town of Coalville. It is easily accessed by public transport from the City of Leicester. The Care centre is an attractive and distinctive centre set in very large, attractive woodland, in which there are walks for residents that are mobile. Accommodation is located on three floors, which can be accessed by a shaft lift. The home has forty-five single bedrooms and twenty double bedrooms many are en-suite and some open directly onto the garden. The home offers numerous lounges and dining rooms and specialised bathing facilities are available throughout the three floors of the home. At the time of the inspection there are fifty-six residents living at the home. The fees range from £311 to £800 per week depending on the level of support required. Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over nine hours on 16th November 2006. The main method of inspection was ‘case tracking’ which meant selecting three residents and tracking the quality of their care by checking records, discussion with them and with staff and observation of care practices. Altogether, six residents, four staff members and two relatives were spoken with during the course of the inspection. Staff records were looked at and a partial tour of the premises also took place in order to assess environmental standards. Information gathered prior to the inspection has also been used to reach judgements about the quality of care. The registered manager was on annual leave on the day of the inspection. A senior nurse in charge helped in gathering information throughout the day. The inspection included a thematic enquiry as part of a national pilot scheme. This consisted of asking a series of standardised questions to those residents that were spoken with. The results of the thematic enquiry are recorded under the two relevant outcome groups, Choice of Home and Complaints and Protection. What the service does well: What has improved since the last inspection? Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 6 Records are held securely in the offices on each floor. This is important for safeguarding residents right to privacy and confidentiality. 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. Markfield Court Care Centre DS0000001917.V319447.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 Markfield Court Care Centre DS0000001917.V319447.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): 1, 2, 3 and 5 Quality in this outcome area is adequate. There are opportunities for prospective residents to visit the home and obtain necessary information before deciding to move there. But the needs of prospective residents are not adequately assessed before being admitted to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence below is relevant to the thematic enquiry undertaken during this inspection. Residents spoken with confirmed that they visited the home before moving in and one resident commented on having time with the manager to discuss their interests and support. One relative recalled the manager visiting her relative in care to assess his needs, but no one else spoken with could remember if this Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 9 happened. A copy of the physical and social assessment, which is filled in when residents are admitted was seen for the three residents case tracked. Only one of the three residents had on their file a copy of the placing authority’s community care assessment and the pre-admission assessment undertaken by a senior staff member of the home. No pre-admission information could be located for the two other residents. A requirement has been made in respect of this. All of the residents spoken with indicated that it was their relatives that were in charge of costs and finances to do with their placement. No residents or relatives could recall ever receiving an up to date Service User Guide or signing a written contract or statement of terms and conditions but both relatives stated that they were notified if there was an increase in charges. A copy of the brochure that is given to new residents was supplied during the inspection. It contains information about activities, meals and facilities in the home. There is a Statement of Purpose for the home, but this is in need of updating to reflect the recent changes in ownership, staffing arrangements and registration. A recommendation is made in respect of this. A copy of the contract used was also supplied, as no copies of signed contracts were found on the files of residents’ case tracked. There was, however a copy of a letter that is sent to relatives requesting they sign both copies of the contract and return one of them. The contract contains information on fees including a breakdown of any fee that is paid by the local Primary Care Trust. Markfield Court Care Centre DS0000001917.V319447.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 and 10 Quality in this outcome area is adequate. Some improvements to record keeping and medicine management are required to ensure health and personal needs are safely and adequately met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A physical and social care assessment is carried out on residents’ admission then care plans are developed based on this information. Procedures for infection control are detailed on care plans for personal hygiene but there is not enough information specific to individuals’ preferred routines. Although some care planning documentation seen indicates some discussion with residents and relatives, those spoken with are not familiar with care plans and what they are for. Recommendations are made in respect of these two points. Daily records are used to monitor ill health and injuries, which are crossreferenced with relevant accident records. There are various assessment Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 11 tools, for monitoring continence, nutrition, falls, moving and handling and risk of pressure sores, which along with care plans are reviewed on a regular basis. One of the residents’ case tracked is spending a lot of time in bed and needs assistance with moving and handling and transfers. There are no repositioning charts in place for this resident, for minimising risk of pressure sores. There were no charts seen for another resident case tracked, even though using a chart is referred to in a relevant care plan. A recommendation is made in respect of this. Staff were observed interacting with residents in a respectful manner and knocking on residents’ doors for their permission before entering. Staff spoken with identified ways to ensure the dignity of an individual when providing intimate care. Comments made about staff conduct were mainly positive for example “I am looked after well” and “… has a gentle voice and got good manners”. Some errors were found with medication practice. Even though left over medication from the previous cycle had been carried forward, (which is good practice), what had been signed as given and the remaining quantity of medication counted still did not tally. For one medicine in particular it stated on the MAR that seventeen tablets were carried over but only two were remaining, when there were three days of the current cycle still left to go. There were gaps found on the MAR sheet for one medication but the monitored dosage system (MDS) pack was empty for that dose, so it had not been signed as given. Medication has been borrowed from another resident to provide for the increase in dose until the next cycle. This is bad practice as the prescription has been made out to the other resident and belongs only to them. Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Meeting residents’ recreational needs and maintaining contact with family and friends is managed well in accordance with residents’ wishes. There are good arrangements in place for providing wholesome appealing meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Every Thursday morning the bar is opened for residents, their relatives and tenants of the neighbouring retirement village. Both residents and relatives were observed enjoying each other’s company and a glass of wine or tipple of whiskey. That afternoon some residents and relatives were taking a trip to the local garden centre. A resident spoken with said she enjoys the bingo sessions and carpet bowls. There is also a church service held every alternate Sunday. Daily records include what activities individuals’ have participated in, also including board games and movement to music. Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 13 Relatives spoken with confirmed that they are always made to feel welcome and can join in on activities. A number of relatives were seen throughout the day visiting people. There is a phone room so that residents can speak with their friends and relatives in private. There are excellent choices for meals every day. On the day of the inspection there were four choices; turkey hot pot or turkey curry, braised liver and onions or range of salads, jacket potatoes with range of fillings and omelettes. Choices for the evening tea were salads and jacket potatoes, beans on toast or home made mushroom soup. Menu records show that healthy and wholesome meals are provided. Residents spoken with confirmed they enjoy their mealtimes. Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is adequate. Concerns and complaints are not taken seriously enough unless the Complaints Procedure is always followed and everyone feels comfortable enough to make complaints. Staff understand their responsibilities under Safeguarding Adults procedures, which helps ensure residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence below in relation to the Complaints Procedure is relevant to the thematic enquiry undertaken during this inspection. Since the last inspection three complaints have been received by the Commission, which were referred back to the Provider for them to investigate using their own Complaints Procedure. The Complaints file contains a record of these complaints and what action has been taken. Two relatives spoken with brought up complaints they made to the manager in the last few months. Even though both relatives feel their complaints are listened to, no record of these complaints were in the complaints file. One relative spoken with said they had seen the Complaints Procedure displayed in the home but nobody spoken with could recall receiving Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 15 information on how to make complaints. One resident spoken with was worried about being identified during the inspection because he did not want to “rock the boat” and jeopardise his placement. Since the last inspection there has been one completed Safeguarding Adults investigation following an allegation against a member of staff. The notification received by the Provider indicates that the completed investigation was conducted appropriately in accordance with Safeguarding Adults policy and procedures. The registered manager was unavailable on the day of the inspection to discuss further. Staff members spoken with were asked how they would respond in certain scenarios. Staff demonstrated an understanding of confidentiality and their responsibilities to whistle-blow and alert the manager of any allegations of abuse disclosed to them. Markfield Court Care Centre DS0000001917.V319447.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. On the whole, the environment is comfortable, homely and kept clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On a partial tour of the premises the home appeared to be reasonably decorated and maintained. There were no areas observed to be in need of repair. The pre-inspection questionnaire states that there has been no redecoration in the home since the last inspection, which is now over a year. There is a large laundry room containing industrial washers and driers, which is appropriate to the size of the home and the needs of residents. On a tour of the premises the environment appeared clean. Staff members spoken with Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 17 understand the importance of infection control and how their practice can ensure this for example, using gloves and aprons. Markfield Court Care Centre DS0000001917.V319447.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. Recruitment practices protect residents. Further progress with getting the staff team qualified and improving staffing levels will help ensure the needs of residents are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rotas seen show inconsistency with the number of staff working particular shifts. This appears to be as a result of lack of availability of staff due to leave or training, as opposed to being reflective of the number and needs of residents. Residents, relatives and all four staff spoken with identified staffing levels as being a problem at the home. Two of the complaints referred back to the Provider were concerning staffing levels. A resident spoken with commented that the staff team never have any time to talk with him. Staff spoken with also identified this as a problem. One resident commented that “bedside manner [of some staff] not always good because of shortness of time”. Staff members commented that “everyone is shattered” and that dependency levels have changed. There are now more residents that need two carers to use hoist and need assistance with eating and drinking. Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 19 On the day of the inspection some staff were doing a moving and handling course and Protection of Vulnerable Adults training is being provided the following week. Staff spoken with are content with the training they receive and confirmed that they attend refresher mandatory training. The records seen indicate that mandatory training is mainly up to date. Other courses relevant to the needs of residents are also accessed, such as dementia, continence, pressure care and wound management, care planning and the ageing process. According to the pre-inspection questionnaire six of the thirty-nine care staff hold National Vocational Qualification (NVQ) level 2 or above. This is way below the national minimum standard of fifty percent of care staff. Four care staff were observed working towards their NVQ with their assessors. Work towards the fifty percent target must continue. Out of the four staff files randomly selected all except one file contained evidence of identification, two written references, a criminal record bureau check and a POVA First check, obtained prior to the staff member commencing their employment. The other file was a staff member that has transferred to the home from another home part of Southern Cross. Recruitment information must also be transferred over as a matter of urgency to comply with the regulations. Markfield Court Care Centre DS0000001917.V319447.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is adequate. The staff team is not being appropriately managed. There are good organisational arrangements in place for monitoring quality at the home, which seek the views of residents and their relatives / representatives. Financial interests and the health, safety and welfare of residents are safeguarded. This judgement has been made using available evidence including a visit to this service. Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 21 EVIDENCE: It was very clear from discussion with staff, relatives and residents that staff morale is very low and that this is having an effect on the atmosphere of the home. All of the staff spoken with indicated that they are frightened of the manager and are scared that they will lose their jobs. The pre-inspection questionnaire states that since the last inspection forty staff have left their jobs. A complaint made by a relative, that was referred back to the Provider alleged that the manager is “snappy” with residents and staff. People spoken with during the inspection also gave this impression. Staff do not feel supported and listened to. No supervision records were seen on the four staff files randomly selected. All of the feedback was consistent. A staff member also reported that they had been disciplined following an error but there was no record of the incident on their file. Relatives spoken with confirmed that they have received questionnaires about the quality of care. A relative reported that they feel able to tell the truth because the questionnaires are going to head office and not returned directly to the home. Residents have not had their questionnaires distributed yet, which is a fundamental part of the process. Practice audits for medication, health and safety and the environment are undertaken on a monthly basis. Residents spoken with confirmed that they have access to and can spend their money when they want to. Financial records and money for one resident were seen and appeared to be in order. The pre-inspection questionnaire shows that the servicing of equipment and electrical systems are all up to date and there are measures in place for the control of Legionella. On a tour of the premises substances hazardous to health were found held securely and the fire log shows that all the required fire alarm tests are undertaken. Markfield Court Care Centre DS0000001917.V319447.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 2 3 2 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 1 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 1 3 X 3 2 X 3 Markfield Court Care Centre DS0000001917.V319447.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. 2. Standard OP2 OP10 Regulation 14 13 Requirement Timescale for action 01/12/06 3. OP16 17, 22 Ensure all prospective residents’ needs are assessed before they move to the home. Ensure there are adequate 30/11/06 arrangements in place for the recording, handling, safekeeping and safe administration of medicines received into the home. This refers to: 1. Ensuring all medicines administered are signed for on the Medication Administration Record. 2. Ensuring all medicines signed for are administered (Quantities left over did not tally with what is recorded.) 3. Ensuring medicines administered are prescribed to that individual, medicines prescribed for others are their property and must not be used. Ensure all complaints are 31/12/06 investigated using the Complaints Procedure and a copy of all complaints and action taken is held in the home. DS0000001917.V319447.R01.S.doc Version 5.2 Markfield Court Care Centre Page 24 4. OP27 18 5. OP32 17 Ensure staffing levels are appropriate to the needs of residents at all times. Revisiting current staffing levels was made a requirement at the last inspection, initial timescale 17/11/05. Supply evidence by the timescale that the needs of residents have been assessed in relation to dependency levels and staffing numbers. The registered person shall maintain in the care home records as specified in Schedule 4. This refers to ensuring there are records of all disciplinary action in respect of all persons working in the home. 31/01/07 31/12/06 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 OP1 OP7 OP7 OP8 OP27 Good Practice Recommendations Update the Statement of Purpose and all other information about the home. Ensure care plans are drawn up with residents and their relatives, evidence their involvement with signatures where possible. Ensure care plans are detailed and provide information specific to individuals’ preferences. Ensure re-positioning charts are in place for residents that have pressure sores or at high risk of developing pressure sores. It is recommended that the registered provider provide the staffing hours as recommended by the Department of Health Residential Forum and considers the size and layout of the home when making these considerations. Continue working towards the overdue target of 50 of DS0000001917.V319447.R01.S.doc Version 5.2 Page 25 6. OP28 Markfield Court Care Centre 7. 8. OP29 OP36 staff team qualified to at least NVQ level 2. Ensure there is a copy of each staff members recruitment checks held in the home. Ensure staff are appropriately supervised. Markfield Court Care Centre DS0000001917.V319447.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Markfield Court Care Centre DS0000001917.V319447.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. 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