Inspection on 05/04/06 for Meadows Sands Care Home

This inspection was carried out on 5th April 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.

Other inspections for this house

Meadows Sands Care Home 08/12/09

Meadows Sands Care Home 10/06/09

Meadows Sands Care Home 02/08/07

Meadows Sands Care Home 03/08/06

Meadows Sands Care Home 19/12/05

Meadows Sands Care Home 24/08/05

Meadows Sands Care Home 14/12/04

Meadows Sands Care Home 23/08/04

Meadows Sands Care Home 10/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Meadows Sands Care Home 98 South Parade Skegness Lincs PE25 3HR Lead Inspector Dawn Podmore Unannounced Inspection 5th April 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 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. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Meadows Sands Care Home Address 98 South Parade Skegness Lincs PE25 3HR 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) 01754 762712 Accredited Care Limited Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26) of places Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:Old age, not falling within any other category (OP) (26) Dementia - over 65 years of age (DE[E]) (26) The maximum number of service users to be accommodated is 26. 2. Date of last inspection 19th December 2005 Brief Description of the Service: Meadow Sands Care Home is situated on the sea front at the Southern end of Skegness. There are public car parking facilities to the front of the home and three car park spaces to the rear of the home for staff. The home has no garden but seating is available at the front of the building and there is a park across the road. The bedrooms are situated on three floors accessible by stairs or a passenger lift. There are communal lounges and dining facilities on the ground floor. The home does not have a Registered Manager but an acting manager has been in post since August 2005, an application has not yet been received by the Commission to consider the managers fitness for Registration. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 6 hours. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A partial tour of the premises was conducted and staff records were examined. Seven residents, a district nurse and four members of staff, including the manager and the cook, were interviewed. Questionnaires were also left at the home to enable people to comment on the care being provided. On the day of the visit 14 people were living at the home. The manager confirmed that fee rates were due to increase from April 10th new fees will range from £335 - £415 depending on the residents assessed needs. What the service does well: What has improved since the last inspection? What they could do better: Ten requirements and 4 recommendations were made during this visit, 11 of which are outstanding from previous inspections. The home could not show that an assessment of a new residents needs had been carried out prior to them being admitted to the home. It is important that these take place to ensure that the environment is suitable and safe, and that staff have had the appropriate training to meet their needs. On the day of the visit the manager was told that no further admissions must take place without the correct information being obtained first. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 6 Although care plans have been rewritten and improved they still need more detail adding to provide a clearer picture of peoples individual needs and preferences. This will ensure that the residents are looked after appropriately. The home does not provide a programme of activities and care staff carry out any social activities that do take place. As stated at the last inspection residents should be consulted about what they would like to do and their preferences recorded. Then a programme needs to be devised that takes into consideration the differing needs and interests of the people who live at the home. A lockable facility, such as a cupboard or drawer, must be available in bedrooms so that residents can keep any valuables and/or medications securely. People should also be asked if they wish to have locks fitted on their bedroom door to provide privacy, any decisions should then be recorded in care plans. Currently staff receive a basic induction to the home. This needs to be improved so that the home ensures that new staff have been provided with all the essential information they need about the running of the home, and the care they will be providing. The home needs to ensure that all staff receive regular recorded supervision sessions to help them identify any areas that they need support with. Essential training in areas such as basic food hygiene, administration of medications and the safeguarding of adults must also be provided. This is important so that staff have enough knowledge to enable them to provide a good standard of care and protection to the residents living at the home. Although owner has completed some reports of his monthly visits to the home these must be carried out consistently, and the content should reflect the current issues at the home and how these are being addressed. Risk assessments have been carried out regarding the safety of the home’s environment, this information should now be used to minimise identified risks and thereby protect residents and staff from unnecessary harm. The home also needs to introduce a system to evaluate the kind of service it is providing; this needs to include obtaining the views of the people who live at the home, and their relatives if appropriate. 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. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 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 Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 The home is not assessing peoples care needs adequately prior to admission. EVIDENCE: The home has admitted one resident since the last visit. The manager could not demonstrate that she had assessed their care needs prior to agreeing to admit the resident. Although this was an emergency admission and the manager did not have time to visit the resident prior to admission, essential information should have been obtained and documented. A social service assessment was on file however this was dated March 2005 therefore the information was out of date. An immediate requirement was left following the inspection, which required the home to ensure that they fully assessed people’s needs prior to agreeing to admit them. The home does not provide intermediate care. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 9 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. Care plans did not contain enough information therefore people’s needs may not be met. Residents’ health needs are being met appropriately. Shortfalls in the medication procedures and the lack of staff training in the administration of medication could put residents at risk. Residents are treated with dignity and respect. EVIDENCE: Each resident has an individual plan, which contains information relating to his or her care needs. Over the last 3 months all plans had been rewritten. Although there has been an improvement in the documentation of care needs further development is required. Areas not fully addressed included nutritional and pressure risk assessments. Individual residents personal likes and dislikes were documented but could be expanded to provide staff with more detailed information, this is particularly important for people with communication problems. Plans seen had been regularly reviewed but some evaluation records consisted of just a date therefore did not document any progress or deterioration in the resident’s condition. The content of the daily notes in each file had improved since the last visit providing a good record of resident’s day-to-day lives. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 10 Plans did not show that residents had been consulted about their care needs and preferences therefore the planned care may not reflect their wishes. Residents’ health needs were being met. Visits by doctors and district nurses were recorded in residents’ files. A district nurse visiting the home on the day of the inspection stated that although she did not visit the home regularly she felt that the staff care for people appropriately and communicated well with the district nursing team. Although a new medication procedure has been introduced since the last visit the section regarding the daily administration routine has been omitted. The team leader was observed administering medications appropriately and medication records had been completed correctly. A discussion with her showed that she understood the correct procedures to follow but although she had attended trained regarding the system in use she had not received any training regarding the safe handling of medications. All staff administering medications must receive appropriate training in the safe handling of medicines as well as the systems used by the home. People living at the home said that staff respected their privacy and treated them with dignity and respect. They also confirmed that their care needs were being met. Staff were observed attending to residents appropriately and during discussions gave examples of how they met peoples individual needs. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 11 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 The home does not provide an appropriate programme of activities. Residents’ are offered choice regarding their daily lives. Meals provided offer variety and choice. EVIDENCE: The home does not employ an activities coordinator therefore any social stimulation is provided by the care staff. Although the home was required to formulate a suitable activities programme in the last inspection report this has not been addressed. This means that residents may not be receiving appropriate social stimulation. Residents commented that there was not much to do during the day and staff confirmed that only occasional activities took place. Care plans did not address the social needs of residents in sufficient detail especially in relation to people who have a communication problem or dementia. Residents comments regarding activities include: ‘nothing really happens’, ‘the staff don’t have time to sit and chat to you’ and ‘I’m happy spending time in my room and would prefer not to join in anyway’. There were no visitors present on the day of the visit but residents said that their friends and families visited when they wanted to and were always made welcome by staff. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 12 Residents and staff gave examples of how choice was offered at the home, this included: times for getting up and going to bed, meals provided and how they spent their day. Lunch on the day of the visit was well presented and nutritionally balanced. It consisted of gammon and pineapple with potatoes and vegetables followed by strawberry crumble and custard. The cook said that he had held a meeting with residents to discuss alternatives to the current menus. He said that he also intended to introduce a menu option system to enable residents to choose their meals the day before, if they were able to. Meals can be taken in the dining room or in the privacy of the residents’ bedroom. Residents’ comments included: ‘we get plenty to eat and you get a good cup of tea’, I’m happy with the meals I get’ and the foods good, it is home cooked and now we get homemade cakes and buns too’. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 13 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 & 18 The home has satisfactory procedures for handling complaints. Residents are protected by the home’s procedures for handling allegations of adult abuse but shortfalls in staff training puts people at risk. EVIDENCE: The home has a complaints procedure, which tells residents and relatives how to make a complaint and how it will be handled. A copy is given to each resident on admission and forms part of the Service Users Guide, which is available in every bedroom. Residents’ spoken to and a visiting district nurse made positive remarks about the home. As the Commission had not provided questionnaires to the home prior to the visit some were left on the day so that people could share their opinion of the home. The home has an adult protection policy to tell staff about the procedure to follow if they have any concerns. Induction and training records did not demonstrate that all staff had received appropriate training and instruction regarding this subject; staff comments confirmed this. This means that people may be put at risk due to lack of information. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 14 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, 24, 25 and 26 Residents living at the home live in a clean, comfortable and homely environment. The home is not providing a lockable facility in all bedrooms for residents to safely keep valuables, and where appropriate medication. EVIDENCE: Communal areas have a homey atmosphere and were clean and tidy. The three bedrooms seen during this visit were well maintained and furnished, including personal mementoes and small items of furniture. Residents said that they were happy with their rooms and the facilities the home provided. Comments included: ‘I love my room, it has a sea view’ and ‘I have everything I need’. At the last inspection it was identified that the rear stair carpet was threadbare in areas along the edge of each step, which is a potential hazard to residents and staff. The manager has completed a risk assessment, which directs staff not to use the stairs, but to date no further action has been taken to address the issue. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 15 The programme to cover radiators to protect residents from possible harm is still underway with further radiator covers fitted since the last inspection. Risk assessments have been completed and a priority list has been formulated. Locks are not provided on residents’ private accommodation. At the last 3 inspections the home was asked to consult with residents to see if they would like a lock fitted, and if so an assessment completed to ensure that this is appropriate for individual residents. There was no evidence available to show that residents had been consulted regarding this issue therefore their wish for privacy cannot be assured. The home is not providing a lockable facility in all bedrooms for residents to safely keep valuables, and where appropriate medication. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 16 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 The home is meeting minimum staffing levels. The shortfalls in staff induction and training could lead to residents’ needs not being met and people being put at risk. EVIDENCE: The manager is supernumerary to the staff rota and a team leader is on duty throughout the day to aid the smooth running of the home. On the day of the visit 3 staff were on duty in the morning and 2 in the afternoon, this was to care for the 14 residents currently living at the home. At the last inspection it was recommended that the home improve its documentation regarding dependency levels to demonstrate that there are enough staff on duty to meet the needs of residents, this had not been addressed. Residents commented: ‘the staff are wonderful’, ‘they sometimes seem to be short of staff, they don’t have time to talk like they use to’, ‘the staff are generally good, some are better that others’ and ‘the staff are nice and helpful, they know what I need’. Staff said that there was enough staff on duty to care for people but not to take them out or do many activities. One identified that the home was short of staff due to people leaving but confirmed that the home had advertised for new staff. Staff comments and the examination of their recruitment files demonstrated that they had been recruited correctly. This included a Criminal Record Bureau (CRB) check and two satisfactory references being obtained before they started to work at the home. It was identified at the last visit that not all staff Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 17 had documentation on their files to confirm their identity. The manager stated that although not all files contained this information she had requested that staff bring in the documents required for copying, a notice to this effect was seen on the office wall. The induction programme for new staff continues to be very basic so does not demonstrate that staff have received all the essential information they need to carry out their work or that they are competent to do so. It still does not include caring for people with dementia or the protection of vulnerable adults; these are needed to ensure that staff understand peoples needs and how to deal with concerns correctly. Three staff interviewed said that they enjoyed working at the home. Staff records and comments demonstrated that although training in subjects such as manual handling, dementia, and first aid, basic food hygiene and fire safety had taken place not all staff had attended these sessions. Training needed included: basic food hygiene and adult protection. Staff administering medication must also receive appropriate training in this subject. The manager could not provide details of who had attended each training session so did not know what training individual staff needed. It was recommended that the manager collate information relating to which training staff have undertaken so that she can formulate a training plan for the current year to ensure that all staff have received essential training. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 18 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, 36, 37 & 38 The home does not have a system in place to gain peoples views about the service it provides. The home handles resident’s finances appropriately but improvements could be made regarding documentation. Shortfalls in staff supervision could lead to residents’ needs not being met. EVIDENCE: The acting manager has been in post since August 2005 but an application to the Commission for her registration had not been received. The provider should address this situation as soon as possible. Although this has been a requirement for over a year the home still does not have a system in place to gain the views of people who use the service. Residents meetings had not been held and there was no documentation to show that residents or relatives had been consulted about the day-to-day operation of the home. One resident commented that she was happy at the home but wished she saw the new owners as much as she saw the old ones. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 19 The office administrator is responsible for the safe keeping of residents’ personal monies. Accounts sampled were found to be satisfactory, however as identified at the last inspection there needs to be improvements to the current recording system to include two signatures (where possible one of which should be the resident) when transactions are made. Residents do not have access to personal monies at a weekend or evening and the provider needs to assess this situation and ensure that people are aware of arrangements in place. Although the manager has introduced a staff supervision system records showed that not all staff had received these sessions, these are needed to provide support and development for staff. The Registered Provider needs to visit and complete a monthly report detailing his findings at the home. These reports had been provided to the Commission in January and February and copies were available in the home, but there was no report for March. The reports seen did not demonstrate that the management team were monitoring the issues identified in the last inspection report. As well as the good things about the home the reports should include the areas needing attention to show that action is being taken to meet identified requirements. Environmental risk assessments that are carried out to ensure that the home is as safe as possible had been completed. The fire officer had recently approved a new fire risk assessment. Risk assessments for the gas fires in lounges and the threadbare carpet on the back stairs had been completed but the provider should make sure that actions identified to minimise these risks are followed through. The Environmental Health Officer had recently visited the home to inspect the kitchen area. His report highlighted that the seals on the freezers were dirty and needed cleaning, and that the table mounted can opener was also dirty and needed regular cleaning. The manager confirmed that the freezer seals were to be replaced and the can opener had been added to the routine cleaning schedule. During the tour of the building servicing labels were checked on fire appliances and moving and handling equipment, these showed that regular servicing had taken place. Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 1 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X 2 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 2 2 3 Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 21 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 OP3 Regulation 14 (1) Requirement Documented, comprehensive assessments must be undertaken prior to the admission of a service user to ensure that the home can meet their needs. The previous timescales of 01/02/05, 11/09/05, 19/12/05 and 7/2/06 were not met. An immediate requirement notice was issued during this visit stating that new residents could not be admitted without a comprehensive assessment being obtained. Care plans must provide sufficient detail regarding all of the resident’s needs and preferences. They must be regularly reviewed and evaluations documented. Plans must be revised as necessary. The previous timescales of 01/06/05, 01/10/05 and 31/01/06 were not fully. Timescale for action 05/04/06 2. OP7 15(1) (2) (c) (d) 22/05/06 Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 22 3. OP9 17 (2) (3) (i) The homes policy and procedure must include all of the information needed to enable staff to administer medications safely. The previous timescale of 31/01/06 was not fully met. The home must consult with service users then formulate and implement an appropriate social activities programme. The previous timescale of 31/03/06 was not met. All service user bedrooms must have a lockable facility for the storage of personal possessions and where appropriate medications. Previous timescale still valid There must be evidence of a staff members identity held within their recruitment file as described in Schedule 2. Previous timescale of 28/02/06 were not met. All staff must attend mandatory and specialist training to meet the needs of the residents living at the home This includes adult protection, basic food hygiene and if appropriate medication training. New staff must undergo a comprehensive, documented induction programme. The previous timescales 01/05/05, 01/10/05 and 31/03/06 were not fully met All staff must receive regular appraisal and supervision as required. The previous timescales of 01/03/05 01/11/05 and 29/02/06 were not met. 01/05/06 4. OP12 16 (2) (m) 01/06/06 5. OP24 13 (2) 30/06/06 6. OP29 19 (1) (b) (i) 08/05/06 7. OP30 18 (1) 01/08/06 8. OP36 18 (1) (a) 2 22/05/06 Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 23 9. 10. OP37 OP38 26 (1) (4) (5) 18 (1) 16 (2) Monthly visits must be made by the provider and documented in accordance with Regulation 26. Food handling, hygiene and safety training must be provided for all staff involved in food preparation and handling. The previous timescales of 01/04/05, 01/11/05 and 31/03/06 were not fully met 01/05/06 01/08/06 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. 1. Refer to Standard OP7 OP24 Good Practice Recommendations Care planning documentation should be amended to ensure staff have sufficient space to identify all care needs and evaluation comments. To maintain service users privacy the home must provide appropriate locks to service users accommodation or evidence that these have been either offered and refused or risk assessed as not advisable. The manager should continually assess and record the changing needs of service users living in the home, by assessing dependency levels to ensure staffing levels meet their needs. The manager should audit staff training files and produce a summary of training undertaken. This information will assist her to develop a suitable training programme for the coming year. The manager should make sure that two signatures are obtained, preferably one being from the resident or relative, for all transactions of personal monies held in safe keeping by the home. Arrangements should be made for service users to have access to personal monies outside office hours. Service users should then be informed of these arrangements. 2. OP27 3. OP30 4. OP34 Meadows Sands Care Home DS0000002552.V288304.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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