Inspection on 24/01/06 for Medihands Clifton

This inspection was carried out on 24th January 2006.

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

Medihands Clifton 04/02/09

Medihands Clifton 05/02/07

Medihands Clifton 16/09/05

Medihands Clifton 08/11/04

Medihands Clifton 19/04/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Medihands Clifton 17 Bodley Road New Malden Surrey KT3 5QD Lead Inspector David Pennells Unannounced Inspection 24th January 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 Medihands Clifton DS0000013380.V281510.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. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Medihands Clifton Address 17 Bodley Road New Malden Surrey KT3 5QD 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) 020 8949 3581 02082412664 Mrs Jayashree Sawmynaden Marion Grubb Care Home 15 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (12) of places Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th September 2005 Brief Description of the Service: ‘Medihands’ is a small private organisation providing residential services predominantly to adults with mental health issues in three homes and - in the case of this home, Clifton Medihands, providing care for older people, including some people with dementia. Clifton Medihands is a small and pleasantly domestic house that accommodates up to fifteen service users (65 ), currently the registration category allows for three service users to have a specific diagnosis of ‘dementia’. The home is an ordinary house in an ordinary street in New Malden, relatively close to the main road (A3) and the centre of New Malden. Transport links - by bus and train - are relatively close by. The home provides bedrooms over both the ground and first floors, and all the communal areas are situated on the ground floor. The main lounge extends from the dining area - providing substantial space, and there is a smaller sitting area - predominantly used by staff - close by the kitchen. The lounge overlooks a pleasant, small, domestic garden, and the front door and ground floor bedrooms face out into the street - Bodley Road - which is open, wide and remarkably quiet; parking is easy either in the horseshoe driveway of the home itself, or - at no charge - on the street itself. The home is managed by Mrs Marion Grubb - the registered manager, and overseen closely by Mrs Sawmynaden (known as ‘Mrs Sammy’) - the owner. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit was conducted from 9.30am to lunchtime on an ordinary working day. The inspector was pleased to meet many service users, to encounter staff, and to meet with the manager of the home. The latter was able to assist the inspector in reviewing the requirements set at the previous inspection visit - and to provide information for the assessment of the core standards not previously covered at the September 2005 inspection visit. The inspector took his leave of the house following chatting to service users sitting at the table enjoying their lunch. The inspector is grateful to all at the home for their welcome, cooperation and hospitality. What the service does well: What has improved since the last inspection? The number of requirements has dropped from 25 to 16 on this occasion though this figure would be substantially lower if a number of issues had been fully completed / addressed prior to this unannounced visit. It is good to see the manager addressing the ‘dementia’ care issue - though this may well take some time to ‘move’ the home towards its obvious speciality. Small housekeeping items - such as ensuring medication records are complete, that crockery provided is adequate, that safety is ensured through providing appropriate mechanisms on door locks, that cross infection chances are Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 6 minimised through scrupulous cleaning, and that identified safety hazards are removed, have all contributed to an enhanced sense of proper wellbeing for all. 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. Medihands Clifton DS0000013380.V281510.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 Medihands Clifton DS0000013380.V281510.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 & 4. Service users can expect to be provided with adequate information about the home, including a fully detailed contract that will reassure them that they have some ‘security of tenure’ within their room and the home. Service users can be assured that their needs will be fully assessed against the service available at the home, prior to their admission being agreed. Service users can expect the home to competently meet their general ‘ageing’ care needs, though the home must focus more substantially on the needs of service users with dementia or those who are exhibiting signs of dementia. EVIDENCE: The home has previously been commended for its Statement of Purpose and Service User guide; these elements were therefore not inspected this time. The service user’s contract has is also now acknowledged to be ‘up to standard’. The first and third judgement statements are brought forward from the last inspection report reflecting the deficit to standard 4. The second statement evidences that standard 3 was assessed this time - and found ‘met’. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 9 Under standard 3, the manager was able to evidence to the inspector that the four care elements of this standard were addressed - initially through undertaking an review of the comprehensive assessment provided by the referring agent - or through using the home’s own assessment documentation. Such documentation included assessments of a history of falls, foot care, continence, mental wellbeing and various other essential strands. The information is then translated into a daily plan of care for each individual. Of the current thirteen service users at the home, it was noted that three were definitively in the ‘dementia’ category and the remaining ten remained in the some degree of ‘pleasant confusion’ or ‘mild confusion’ category. The previous inspection required the proprietors and the manager to arrange a re-assessment of the categories of all service users – to ensure that the home is registered in - and providing a service adequately for - the category most appropriate and fitting to the service. The manager, through contact with contracting managers, has taken some steps to address this issue, however the addressing of the apparent anomaly of having only three places registered to care for people with dementia is still to be resolved fully. Requirements concerning the development of a full activities programme and another regarding training for staff in dementia care are reiterated. The need for staff to enhance their knowledge of working with people who have dementia is vitally important – both due the current registration focus, and also to meet the needs of the remaining frail service users at the home. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 & 9. Service users can expect to have their needs, goals and aspirations mapped out in a care plan specifically identifying their own needs. Service users can expect their health care needs and subsequent medication / treatment regimes to be well supported by the home’s staff, following appropriate procedures. Service users may expect their privacy and dignity to be respected – through the staff providing sensitive and appropriate personal care. EVIDENCE: Standards 8, 9 & 10 were assessed at the last visit with standards 8 & 10 being found ‘met’ and with one requirement being placed against standard 9. This was checked at this visit and this standard is now found ‘met’. The second and third judgement statements above reflect these attainments. Standard 7 was inspected at this inspection and found ‘met’ - this reflected by the first judgement statement above. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 11 Standard 7 relates to the care plans established to guide and inform the care given by staff and to act as a benchmark for assessing the progress of each individual service user. The plans seen clearly demonstrated the care required, and the goals set. Regular written monthly reviews are maintained - looking at the previous fourweek’s history and informing care plan revisions. The home’s Care plans folder and associated health care records were examined and found to be up-to-date. Risk assessments were also found in place relating to identified situations, -all receiving quarterly reviews. The inspector also inspected the medication regime at the home and all was found to be in generally good order - the inspector advising the expansion of a instruction relating to a service user’s Stemetil - being a medication prescribed, ‘prn’ (‘when required’), for sickness. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15. Service users can expect the home to be sensitive to their individual needs and aspirations and choices - recognising social, religious and cultural needs - and encouraging engagement with and the involvement of relatives and friends. The home provides wholesome and nutritious food provided in an environment conducive to service users enjoying this experience, this enjoyment now being enhanced through pleasant crockery being provided. EVIDENCE: All standards in this section were inspected at his last visit - the first three being found ‘met’ and the last having a requirement set against it. The above judgement statements are reiterated from the last inspection report - the second being amended to reflect the requirement being fulfilled. Just standard 15 was inspected during this visit to the home; this had to be revisited as the inspector was previously unhappy with the standard of provision of crockery for service user’s use. He was pleased to observe a matching set of crockery in use at this visit - the beef casserole with potatoes, sprouts and gravy served thereon being thoroughly enjoyed by the service users. Medihands Clifton DS0000013380.V281510.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): None inspected at this visit. Service users and their advocates can be assured that their comments and complaints will be actively listened to, and appropriately handled. The home acts appropriately to ensure that service users as vulnerable adults are recognised and suitably protected from exploitation or abuse. EVIDENCE: These standards were not inspected at this visit; the key standards 16 & 18 were inspected at the last visit and both found to be met; the judgement statements are reiterated for the information of the reader of this new report. Medihands Clifton DS0000013380.V281510.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): All excepting standard 25. Service users can expect the home to respond to issues raised regarding their safety and wellbeing; the home operates generally in a well maintained and safely kept environment. The premises provide generally suitable accommodation for service users, though the use of undersize double bedrooms continues to be challenged. The absence of some equipment such as a shower facility, a passenger lift or similar, and a powered bathing seat may place some service users at risk, due to their frailty and need for this extra assistance. Service users can expect generally to have pleasant and comfortable bedroom surroundings provided to promote their sense of belonging, and to ensure both their privacy and dignity. The home, whilst generally clean and well maintained, needs to address issues around possible cross-infection - to ensure the best and safest standards of hygiene. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 15 EVIDENCE: The home is an ordinary house in an ordinary street in New Malden, relatively close to the main road (A3) and the centre of New Malden. Transport links - by bus and train - are relatively close by. The home provides bedrooms over both the ground and first floors, and all the communal areas are situated on the ground floor. The main lounge extends from the dining area – providing substantial space, and there is a smaller sitting / dining area – predominantly used by staff, close by the kitchen. The lounge overlooks a pleasant, small, domestic garden and the front door and ground floor bedrooms face out into the street - Bodley Road. A requirement set at the previous but one inspection that a maintenance programme for the home be established, with records kept, has now been met. The registered provider was also required to ensure that an (power-) assisted bath seat / chair was provided in the downstairs bathroom; this issue remains outstanding, though steps have been taken to research the issue. Clearly with the frailty, both mental and physical, of many service users, this is an absolutely essential item of equipment to provide -both for them and for the safety of staff members. The front door – for fire safety reasons - is now openable without the use of a key; an electromagnetic door release mechanism having been fitted, which is wired into the integrated alarm system. The issue of the use of bedrooms (No 6 and its ‘footprint’ counterpart) for double occupancy is being addressed (with one presently being used as single occupancy accommodation only), however the Commission has not received the commitment of the proprietor, regarding this issue, in writing. Both of these bedrooms are very significantly under the national minimum standard size allowed, measuring at most 13.5 sq metres - as compared to the minimum standard [NMS 23.8] of 16 sq metres). Those sharing have agreed to do so, and a privacy screen is provided in this doubly occupied room, but the availability of space for personal possessions / furniture and the provision of significant personal care remains, obviously, severely restricted. The manager has indicated that all the eleven single bedrooms in the home (seven upstairs and four downstairs) are under the preferred minimum 10 sq metres. As an existing home, these bedrooms may remain in use - as they provide individual space and privacy – and none is close to the 6.75 sq metres available to those who share a double room (see paragraph directly above). Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 16 The need to maintain a fire passage route through a bedroom (No 3) that has a fire exit door leading from it (and at the time of the inspection a break-glass point behind the wardrobe) has also been identified. Issues raised concerning another bedroom have been addressed. Toilets and bathrooms - which were required (to avoid / minimise the risk of cross-infection) to have liquid soap, paper towels and lidded bins provided (and the cotton [communal] towels removed) are awaiting the delivery of these new items. The facility of a shower - on the first floor - must be restored to working use, to ensure that a variety of facilities are available to meet service user’s varying / cultural needs. A similar facility on the ground floor has now been disabled. ‘Sufficient’ laundry facilities at the home are provided, but the inspector noted previously that the washing machine is clearly not a sluice-cycle machine. The manager confirmed that she was seeking advice from a provider of such machines - in early February 2006. Such a sluice-cycle machine is to be provided to address the probable, if not certain, occurrences of incontinence within the home. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 17 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, 29 & 30. Staffing at the home is provided to meet the basic care needs of service users, however - to fully respond to their evident specialist needs – staffing levels require reviewing and modification. A consistent staff team provides a service that is based on consistency, familiarity and a developing knowledge of each individual’s needs and aspirations. Service users can be assured that the recruitment and employment practices of the home will ensure both appropriate support and protection for them. Staff members are well trained in general care practices; the planned provision of a ‘dementia care focus’ will ensure appropriately sensitive service delivery for the future. EVIDENCE: Standard 29 was not inspected at the last inspection visit; following this visit it is found ‘almost met’. Standard 28 was inspected previously and found ‘met’. Outstanding issues raised at the last inspection relate to staffing levels particularly bearing in mind the ‘half week working of the cook / housekeeper. A number of days each week rely on the care staff to provide both cleaning and cooking input to the home-alongside the caring elements. Whereas the care staff rota at first examination appears adequate, with the hours extracted for ancillary duties, there is clearly a need to review the provision. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 18 Staff training is seen as a real priority at the home; the home has at least 60 of its care staff qualified to NVQ at Level 2 in Care. Training of staff especially those working at nighttimes - in First Aid (a regulatory requirement) is still to be stepped up (six staff are currently qualified) - to ensure that the rota is covered 24/7. Standard 29 has six elements all of which were all found to be ‘met’ excepting the need for the home to ensure that the GSCC (General Social Care Council) document ‘Code of Practice for Social Care Workers’ is obtained and distributed to all staff members (documentary evidence of their receipt should be kept). This is now the Code by which care staff members are expected to operate. Within a short period of time, all care workers will be required to register with the GSCC and it is important to ensure that the underpinning philosophy of caring is acknowledged, and adhered to, in advance of this requirement. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 19 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): 33 & 38. The management input at the home is reliable and skilled in its application; the need for support to the manager – through the appointment of a permanent deputy is currently covered by two in an ‘acting deputy’ role - this will hopefully ensure consistent management supervision and encourage staff development. The home will benefit from the quality assurance surveys and research soon to be implemented at the home; without this feedback service user’s views cannot be fully incorporated into plans for the development of the home. Service users can be assured that financial aspects of their stay will be managed and protected as appropriate – through the home having a clear policy of encouraging advocates’ involvement. Service users can expect their general health and safety to be protected by the maintenance activity and servicing contracts of the home. The improvement of frequency of fire drills will ensure the safety of service users through a more practiced staff being competent to support them. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 20 EVIDENCE: The manager has a clear concept of best practice in the home and is committed to the welfare of the service users. The proprietor Mrs Sawmynaden is a regular visitor to the home and Mr Sawmynaden - the proprietor’s husband, acts as ‘Support Services Manager’ to this home, alongside the other ‘Medihands’ registered services. Responsibilities within the home are delegated to other senior carers, two of which are currently holding onto the ‘acting deputy’ role. The previous requirement that quality assurance / satisfaction surveys be put in place, and the results duly published had progressed as far as the manager informing the inspector that a survey had been created, checked and edited, and it is now ready for distribution. The inspector looks forward to learning of the outcomes of this research. The home does not engage with service user’s finances – preferring relatives / next-of-kin / solicitors / care management to take on this responsibility. The manager again confirmed that neither she nor the proprietors act as appointee to any service user. Health & Safety issues were generally in good order; all records were available for inspection and evidence was available that all maintenance and servicing of equipment within the home has been continued. The inspector requires that Fire Drills be increased in frequency to ensure that all staff members have experienced a drill at least once in each twelve-month period; the last drill was held on 05.07.05. Again, principally, it is the night care staff members that miss out on training initiatives that are relatively easy to undertake for daytime workers. Statutory records such as accident and incident records - and notifications to the commission were fully maintained and well kept. Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 21 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 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 2 2 2 2 3 X 2 STAFFING Standard No Score 27 2 28 X 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 2 Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 22 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 OP4 Regulation 18(1)(a) (c) Requirement The registered provider must ensure that staff members are given training to increase their knowledge and skills in working with people with dementia. Timescales of 01.03.05 & 15.11.05 not met. The registered providers and manager are required to cooperate with the Commission is assessing the specific needs of the service users accommodated at the home and to ensure that the Registration category, the Statement of Purpose and the service provision is appropriate to the needs of the current service users. Timescale of & 15.11.05 not met. The registered provider must [a] devise and implement a structured and planned activity programme to meet the assessed needs of all service DS0000013380.V281510.R01.S.doc Timescale for action 15/03/06 2. OP4 6 & 14(1) (2), 16(1) 15/03/06 3. OP4 16(2)(n) 15/03/06 Medihands Clifton Version 5.1 Page 23 users; and [b] ensure that there is a detailed record of each activity, listing those involved and the success of the activity. This record must be used to support planning for future activities. Though slowly developing, elements of this requirement remain outstanding since originally set at 30.06.04 and a most recent timescale of 15.11.05. 4. OP19 13(4) & 23(4)(c) Bedroom No 3 - with a fire route through it - must have the break glass exposed for use (by the moving of the wardrobe or the break glass location [with fire officer’s permission]), and the evacuation route through the bedroom must be kept available / ‘sterile’ at all times. Timescale of 15.11.05 not met. The standard of furnishings provided by the home (as distinct from service user’s items) must be reviewed - and any which do not meet current Furniture (Fire Safety) Regulations must be replaced with items that do comply with the current standards. Requirement not fully met previous timescale of 15.11.05 not met. The registered provider must ensure that a power-assisted bathing seat / hoist is provided in the ground floor bathroom. Timescale of 01.02.05 not met. Action was due to be taken following a visit from a supplier on 26/01/06. 15/03/06 5. OP20 16(2)(c) 15/03/06 6. OP21 23(2)(n)& 13(4) 23/02/06 Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 24 7. OP21 23(2)(j) Shower fittings in bathrooms must be restored to use to enable a variety of bathing facilities to be available; thus meeting the varying / cultural needs of service users. Part of this requirement has been met; the upstairs fittings remain outstanding for attention since 15/11/05. A passenger lift or a suitable device to enable / assist service users to climb the stairs must be provided at the home to meet their present and future needs. Steps are being taken to address the issue - further surveyors were due to visit the home on 26/01/06. Previous timescales not met. The registered provider must communicate formally to the Commission in writing its intentions with regard to the future use of the two ‘double’ bedrooms - which are only of a size suitable for use as single rooms in the future. A sluice-cycle washing machine must be installed to meet the needs of disinfection standards and to comply with current Water Regulations (26.7, 8 & 9). This issue is being pursued, but is not yet resolved timescale of 15/12/05 not met. All communal bathrooms and toilets must be provided with liquid soap, disposable towels and lidded bins - and to avoid further risk of cross-infection, the cotton (communal) towels must be removed. DS0000013380.V281510.R01.S.doc 15/03/06 8. OP22 23(2)(n) 15/04/06 9. OP23 23(2)(a) (e) 15/03/06 10. OP26 13(4) & 16(2)(j) 15/03/06 11. OP26 13(3) & 16(2)(j) 15/03/06 Medihands Clifton Version 5.1 Page 25 The provision of such materials was imminent timescale of 15/11/05 not met. 12. OP27 18(1) Care staffing input must be reviewed in the light of the clearly growing dependency levels in the home, and bearing in mind the absence of a chef / ‘housekeeper’ on 3 or 4 days each week. Timescale of 15/11/05 not met. The position of cleaner / domestic must be filled with a person working sufficient hours to release care staff from this burden, and also the kitchen domestic duties. Timescale of 15/11/05 not met. The General Social Care Council’s document ‘A Code of Practice for Social Care workers’ must be obtained and distributed to all workers at the home. Training of staff in First Aid must be made a priority over the next few months, to ensure that a competent First Aider covers each night as well as day shift. Fire drills must be increased to being held at least quarterly events to ensure that all staff at the home are annually covered. 15/03/06 13. OP27 18(1) 15/03/06 14. OP29 18(4) 31/03/06 15. OP30 13(4) 30/04/06 16. OP38 23(4) (d) (e) 15/03/06 Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 26 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. Refer to Standard *RCN Good Practice Recommendations Not applicable Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Medihands Clifton DS0000013380.V281510.R01.S.doc Version 5.1 Page 28 - 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!