Inspection on 02/10/06 for Millfield Lodge

This inspection was carried out on 2nd October 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

Millfield Lodge 22/07/08

Millfield Lodge 04/10/07

Millfield Lodge 15/02/07

Millfield Lodge 29/11/05

Millfield Lodge 20/08/05

Millfield Lodge 10/08/04

Millfield Lodge 05/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Millfield Lodge Potton Road Gamlingay Bedfordshire SG19 3LW Lead Inspector Nicky Hone Key Unannounced Inspection 2nd October 2006 12:10 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 Millfield Lodge DS0000015176.V293506.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. Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Millfield Lodge Address Potton Road Gamlingay Bedfordshire SG19 3LW 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) 01767 650734 01767 651434 Ms Anita Ram Care Home 31 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (31) of places Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Millfield Lodge is situated on the edge of the village of Gamlingay. It is located at the end of a short private drive and is within about a mile of the shops, doctors surgery and village centre. Gamlingay is on the CambridgeshireBedfordshire border and is approximately a 30 minute drive from Cambridge city and a 15 minute drive from Sandy. Millfield Lodge is a single storey building and since the last inspection has had a large extension built to the back of the existing home. The home now has thirty one single bedrooms. The twenty new rooms each have a large ensuite shower room; seven rooms have an ensuite toilet, and four rooms have a washbasin. There are two lounges, one of which has a large conservatory attached which has doors to an enclosed patio area. The dining room has been extended and there are two bathrooms and a shower room, as well as a kitchen, laundry room, offices and staff room. The home has plenty of parking space at the front, and large gardens to the rear and side of the building. The fees for Millfield Lodge are £361 per week, or £455 to £600 per week for dementia care. Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out by two inspectors who spent five hours in the home, speaking with service users and staff, checking records, looking at some of the rooms in the building, and speaking with the deputy manager. On the day of the inspection there were 28 service users living at the home. What the service does well: What has improved since the last inspection? This inspection looked at whether the home has met the requirements made following the inspections on 29/11/05 and 31/07/06. There was a total of twenty one requirements from those two inspections: two of these were repeated as the original timescale had not been met. We were pleased to find that eleven of the requirements had been met, meaning there have been improvements in several areas. For example, no fire doors were propped open at this visit, prescribed creams are stored safely, relatives are aware of the complaints procedure, information about service users is now kept on their individual files, and service users have a means of calling for assistance. Care plans have also improved, and there is some good information available, although there is still a lot of work to be done before these are useful working documents for staff. Risk assessments are also being completed. Again, additional work is needed to link these more closely to care plans. Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 6 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. Millfield Lodge DS0000015176.V293506.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 Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not get enough information about new service users to be able to know whether appropriate care can be provided. EVIDENCE: The home has a Statement of Purpose and Service user Guide which were updated when the new building was completed. The manager named in these documents has now left so they will need to be updated again when another manager is appointed. Service users’ contracts seen showed that information about the fee to be paid is included in the contract, and the contract specifies which bedroom the person will be occupying. Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 9 We checked the files of three service users and found an assessment of the person’s needs, carried out by a care manager/social worker before the person was admitted. On the third file, only pages 6 to 9 of the assessment were on the file, indicating that there might have been further information which should have been aquired by the home. We were told that one of the home’s own staff visits service users in their own home, or in hospital, and carries out a written assessment, however these were not seen on the files checked. Standard 6, which is about intermediate care, does not apply to this home as an intermediate care service is not offered here. Millfield Lodge DS0000015176.V293506.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, 9, 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Staff practices in the administration of medication are not good enough to make sure medicines are administered safely. EVIDENCE: A care plan was in place for the three service users whose files were looked at. On the whole the standard of the care plans has improved since the last inspection and there is quite a lot of information, some of which is good. For example, it has been noted that one gentleman likes to wear his trilby when he goes out. However, there is still quite a lot of work to be done before they are useful documents for staff to work from. There are several entries which say “assist” or “prompt” (for example, with personal care) without giving detail of what the service user can do for themselves and what staff need to do. The care plan for one service user contained a lot of information relating to their mental health, but there were no guidelines for staff on the ways in which recent Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 11 changes to the person’s behaviour should be dealt with. Daily notes for this service user recorded that staff have developed a strategy for dealing with one aspect of the person’s behaviour, but there was no indication as to who had decided on this, whether this was used consistently, or whether it was effective. Some risk assessments have been carried out, but have not been followed with a clear management plan. For example, a nutritional risk assessment has been written for one person who has suffered unintentional weight loss, but the care plan written does not reflect the assessment, and the reviews that have been recorded do not reflect either the plan or the assessment. A new member of staff would have difficulty following what should be a story about this area of care for this person. One person’s care plan contained a good social history, and was quite informative in most of the areas of care included in the plan. A community psychiatric nurse, at the home to review this service user’s care, said the file (assessment, care plan, social history, daily notes) gave him good information. A new staff member said she is gradually reading all the care plans: she gets information on what care to offer each person from the detailed handovers which take place at the beginning of each shift. Medication Administration Records (MAR) charts were checked. There were several instances where staff had signed to show that medication had been given, but the tablets were still in the blister packs. There were some gaps in the records where there was no indication of whether the medication had been given, or a code used to show why it had not been given. An immediate requirement was left at the home about this, and this was followed by a letter of concern sent to the owner. During the inspection most of the interactions seen between service users and staff were satisfactory. However, we had some concerns that some of the service users had a degree of difficulty understanding two of the staff whose first language is not English. Millfield Lodge DS0000015176.V293506.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, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home could improve the choices available to service users so that they have greater control over their lives. EVIDENCE: The home employs an activities coordinator who we were told works three mornings and one afternoon a week and a record is kept of the activities each service user joins in. However, staff said when the coordinator is not there, no activities take place as there are not enough staff. On the afternoon of the inspection there were no activities taking place. Several service users were milling around the corridors and around the office as they had nothing else to do. At one point, one staff member was observed attempting to talk to service users who were getting irritable with each other; a second staff member was standing alone in the corner of the lounge reading a newspaper. Service users and their visitors know that visitors are made welcome at Millfield Lodge at any time. Service users choose whether to meet with their visitors in the privacy of their bedrooms, or in the lounges or dining areas. Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 13 Staff told us that service users are able to choose what time they get up, go to bed and where and how they spend their day, however there was nothing written in the two care plans seen which would give staff this information for each individual. Lunch looked and smelled good. Service users spoken with said they enjoy the food offered, and staff said the meals are usually very good. Menus seen showed a varied diet, although only one vegetable was on the menu as well as potatoes. Alternative choices are available for residents who do not like the main meal at lunchtime. Staff said fresh fruit is offered occasionally. A record of food provided is kept, but needs more detail about alternative meals eaten by individual service users. Millfield Lodge DS0000015176.V293506.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): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff were not sufficiently aware of the procedure for dealing with incidents of abuse which means service users could be at risk. EVIDENCE: The home’s Service User Guide, seen in one of the bedrooms, contains information about how to complain, and this is also displayed on the wall in the entrance hall above the visitors’ signing in book. The home keeps a complaints log, and a file with details of any investigations that have taken place. The staff member in charge of the evening shift was asked about protection of vulnerable adults. She was clear that abuse is not allowed but was not clear about what to do if an incident was reported to her. She said she had not seen Cambridgeshire County Council’s protocol but would contact the owner of the home for advice. The person in charge of the home must be able to recognise POVA incidents and must be aware of and able to follow the protocol. Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 15 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, 20, 21, 23, 24, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment in this home is good providing service users with an attractive and homely place to live. EVIDENCE: The recent building work and refurbishment of the existing home have made Millfield Lodge a very attractive home, whose layout is suitable for its stated purpose. The steps at the front of the home mean that people in wheelchairs have to use a different entrance: at the site visit in September the owner said this would be altered. All bedrooms are single, and all except four have at least an ensuite toilet. Twenty new rooms have large ensuite shower rooms. There is now a choice of two lounges for the service users to sit in, although at the time of this inspection no service users had chosen to sit in the new lounge Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 16 overlooking the back garden. The dining room has been extended to accommodate the increased number of service users, and some service users can now choose to eat at a dining table in the conservatory. A site visit was carried out in early September 2006 to get evidence that the refurbished and extended home was suitable to meet the needs of thirty one service users: that visit showed that the home has sufficient communal space, bathrooms and toilets; individual bedrooms meet the space requirements; and rooms are furnished in line with the National Minimum Standards. Some bedrooms seen had evidence that service users are encouraged to bring their own possessions when they move into the home. The laundry has been improved to give staff space to fold clean clothes. The home has no sluice. The gardens all round the home are recovering from the effects of the building work, and the owner said that some further landscaping will be done to bring the gardens back to their former glory. Generally the home was very clean, however there was a smell of stale urine in the corridor near the original lounge, and in one of the bedrooms. Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Numbers of staff on duty, and their recruitment and training are poor so that service users are at risk. EVIDENCE: Staff rotas showed that usually there are five staff on duty in the morning and four in the afternoon/evening (including a senior carer on each shift). There are three staff on duty at night. Before the recent building work, the home was registered for sixteen people. At that time there were three staff in the mornings, three in the afternoon/evening and three at night. The report written following the previous key inspection (on 29/11/05) stated “inspectors were of the view that there may be not be enough care staff – several of the service users were not calm and staff were rushed. Five of the eight relatives/visitors who returned a completed questionnaire to the Commission stated that there were not enough staff on duty”. Since that inspection the number of service users has nearly doubled, but with only two additional staff members in the morning, and one additional person in the afternoon for the extra fifteen service users. The number of care staff during the day is not adequate (see the Daily Life and Social Activities section of this report). Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 18 According to the records of staff training available at the time of this inspection, staff have not received adequate training to meet the requirements of the regulations, and to ensure they have the skills and knowledge to offer good quality care to the service users. Much of the training has been done by other people working at the home. For example, medication training is done by senior staff. Training in care of people with dementia consisted of an hour’s talk by someone from the Alzheimer’s Disease Society, plus ‘coaching’ on the job from one of the managers who is a Registered Mental Health Nurse. The deputy manager said she has just taken over the organisation of staff training and is bringing the records up to date. She said training will be arranged to make sure all the staff receive all the necessary training. Three of the staff working at the home have qualifications which the provider states are equivalent to a National Vocational Qualification (NVQ) level 3 in care, one person has a nursing qualification, and the deputy manager was awarded the Registered Manager Award (NVQ4) in her previous employment. Three staff had been awarded NVQ level 2 but had left, or were about to leave. We were told that three more staff have been registered to undertake NVQ level 2. A new staff member said she has been doing induction training with the deputy manager and has been given a checklist to sign. Staff have not received regular, formally recorded supervision. We asked the deputy manager for the personnel files of three named staff members. When the inspector checked these, we found that one contained no evidence that a CRB or POVA 1st check had been undertaken, and only contained one reference. This file did not contain an application form. The second file, of a care assistant who started work two weeks before the inspection, contained only one reference. The file requested for the third member of staff could not be found. The first of the above files we checked related to a member of staff who is one of three overseas staff who started work at the home in August 2006. The deputy manager checked the other two files and found no CRB disclosures or POVA 1st checks. The inspection on 29/11/05 found that staff files did not contain all the information required by the regulations, and a requirement was made: the timescale has not been met. The CSCI is taking legal advice. Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users cannot be confident that the home is managed well enough to give them a good quality of life and keep them safe. EVIDENCE: At the time of the inspection there was no manager at the home. The previous registered manager, who started work at the home on 16 October 2005, left in January 2006 and since then two more managers have started work at the home and have both left. Senior carers were in charge of the home during the inspection (one in the morning, one in the afternoon), and the deputy manager, who had popped in on her day off, kindly spent time talking to the inspectors and assisting with the inspection. The deputy manager is part time, with her hours having increased recently to four days per week. Two other Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 20 people who have management experience were shown on the rota, working a few hours each week to fit in with their other jobs. The home sends out questionnaires to service users, relatives and other interested people such as social workers and the district nurses, to ask people to give their views on the quality of care offered by the home. The results from last year’s survey were collated into a report and a copy sent to the CSCI. Results from the most recent survey have not yet been produced, but the results of the previous survey were positive. The assistant manager said that a small amount of cash is kept securely for some of the service users who are unable to handle their own money and detailed records are kept. This money is used for small purchases such as hairdressing. A copy of the record is sent to the person’s relatives to show how their money has been spent. These records were not checked. Hazards identified at the site visit in September when a variation to the home’s registration was agreed, had not been rectified. For example, the carpet bar between the bedrooms and the ensuite shower rooms in the new rooms, and a carpet edge in the corridor are trip hazards; there are trip hazards in the courtyard where there is a drop between the paving slabs and a drain cover, and a drop between the edge of the paving slabs and gravel; fencing to one side of the building is unfinished leaving only shrubbery between the path and the sheer drop to the property next door; and the door to a hazardous store cupboard in one of the bedrooms was unlocked. During the inspection a plumber was at the home putting anti-scald valves onto hot water taps in service users’ bedrooms. The door to one of the bedrooms has no door closer, and the door does not close properly over the new carpet. Staff described how a service user is assisted to move by being lifted under her arms. This is bad moving and handling practice which could hurt the service user. Staff training records indicated that staff have not all received adequate training in the topics linked to health and safety: moving and handling, first aid, food hygiene, fire safety and infection control. Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 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 3 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 X 3 3 X 2 STAFFING Standard No Score 27 1 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 3 X 3 1 X 1 Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 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 OP3 Regulation 14(1)(a) and (b) Requirement The registered person must not provide accommodation to any service user until a full assessment of their needs has been undertaken. Care plans must detail the actions required to be taken by staff to meet the needs of the service users and must identify all of the service users’ needs. This is carried forward from 29/11/05 – the timescale had not been fully met. Arrangements must be made for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Records of medication administration must be accurate. An immediate requirement notice was left at the home. Timescale for action 20/10/06 2 OP7 15(1) 30/11/06 3 OP9 13(2) 02/10/06 Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 23 4 OP10 18(1)(a) The registered person must ensure, by training or other means, that staff are able to communicate effectively with service users. This is carried forward from 31/07/06. The timescale was not met. Arrangements must be made to provide adequate and suitable activities for residents. This is carried forward from inspections on 20/08/05 and 29/11/05. The timescales had not been met. The registered person must enable service users to make decisions with respect to the care they receive. Evidence must be available to show that as far as practicable service users have made choices in all aspects of their lives. 30/11/06 5 OP12 16(m) and (n) 31/10/06 6 OP14 12(2) and (3) 30/11/06 7 OP18 13(6) The registered person must 30/11/06 make arrangements to prevent service users being placed at risk of harm or abuse. Staff must receive appropriate training in Protection of Vulnerable Adults. All parts of the care home must be kept free of offensive odours. This is carried forward from 31/07/06. The timescale was not met. The registered person must ensure that at all times adequate numbers of staff to meet the needs of the residents are working at the care home. This is carried forward from 31/07/06. The timescale was not met. DS0000015176.V293506.R01.S.doc 8 OP26 16(2)(k) 31/10/06 9 OP27 18(1)(a) 20/10/06 Millfield Lodge Version 5.2 Page 24 10 OP29 19(1) and schedule 2 Full information as stated in Schedule 2 must be obtained before a person commences employment at the home. This is carried forward from 29/11/05 and 31/07/06. The timescales were not met. Legal advice is being taken. The registered person must ensure that staff receive training appropriate to the work they perform. Staff must receive training in dementia care from a source suitably qualified to offer this training. This is carried forward from 31/07/06. The timescale was not met. The person managing the home must be fit to do so. Staff must receive regular supervision. Evidence must be available for inspection. All staff to receive at least one session within the timescale and regularly thereafter. 20/10/06 11 OP30 18(1)(c) 30/11/06 12 13 OP31 OP36 9 18(2) 31/10/06 30/11/06 14 OP38 13(4)(a) All parts of the home to which 31/10/06 service users have access are so far as reasonably practicable free from hazards to their safety. The hazards identified must be rectified. This is carried forward from 31/07/06. The timescale was not met. The registered person must 31/10/06 provide a safe system for moving and handling service users. Staff must not move service users until they have received appropriate training, and staff’s DS0000015176.V293506.R01.S.doc Version 5.2 Page 25 15 OP38 13(5) Millfield Lodge practice must be monitored. 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 Refer to Standard OP15 OP37 Good Practice Recommendations The registered person should consider making more fruit and vegetables available for service users. The record of food provided should contain more detail about which service users have eaten an alternative meal to that on the menu. Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Millfield Lodge DS0000015176.V293506.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!