Inspection on 03/10/06 for Myford House Nursing And Residential Home

This inspection was carried out on 3rd 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

Myford House Nursing And... 14/10/08

Myford House Nursing And... 19/02/08

Myford House Nursing And... 09/03/06

Myford House Nursing And... 19/10/04

Myford House Nursing And... 11/05/04

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

CARE HOMES FOR OLDER PEOPLE Myford House Nursing And Residential Home Woodlands Lane Horsehay Telford Shropshire TF4 3QF Lead Inspector Joy Hoelzel Key Unannounced Inspection 3rd October 2006 10:10 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 Myford House Nursing And Residential Home DS0000022260.V297443.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. Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Myford House Nursing And Residential Home Address Woodlands Lane Horsehay Telford Shropshire TF4 3QF 01952 503286 01952 504966 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) Redwood Care Homes Ltd Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home may accommodate 30 persons requiring Nursing Care. The home must comply with the Staffing Notice issued by the Shropshire Area Health Authority dated 31 May 2000, in respect of the nursing care beds. 9th March 2006 Date of last inspection Brief Description of the Service: Myford House is a care home for older people, registered to provide both personal and nursing care for up to 40 Service Users, and offers both single and double bedroom accommodation. All three floors are accessible via a passenger lift. The main lounge and dining rooms are spacious and currently undergoing some alterations to the accommodation. The home is situated in the Horsehay area of Telford and is a large detached property set in its own grounds. Weekly fees range from £337.47 - £485.00. Information of the home and the provision of the service are available in the statement of purpose which includes a service user guide. Commission for Social Care Inspection Reports for this service are available from the provider or can be obtained from www.csci.org.uk Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection is the first of unannounced key inspections for 2006/07 and took place over six hours twenty minutes on Wednesday 4th October 2006. It was conducted by one regulation inspector. Twenty seven of the thirty eight National Minimum Standards for older people were inspected. Since the last inspection in March 2006 the registered manager has left the company. A person has been recruited for the position and has been at the home in the acting manager role for three months. A formal application has been submitted to Commission for Social Care Inspection. Thirty four people are currently living at the home. The acting manager was in charge of the premises and was supported by one registered nurse five care staff and ancillary personnel. Three case files were selected for case tracking, staff personnel files and other relevant documents were inspected. Discussions were held with numerous residents, visitors and staff. A tour of the premises was conducted. What the service does well: What has improved since the last inspection? Changes are being made to the recording and documentation of the individual care plans. All residents are having a full revision of their care needs. Two boilers have been replaced for the central heating and hot water system. Some refurbishment and redecoration has taken place. Myford House Nursing And Residential Home DS0000022260.V297443.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. Myford House Nursing And Residential Home DS0000022260.V297443.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 Myford House Nursing And Residential Home DS0000022260.V297443.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 1,3,6 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have their care needs assessed before moving into the home. Relatives, and whenever possible the person requiring care, are provided with the opportunity to visit the home to assess its quality, facilities and ability to meet an individual’s needs prior to admission EVIDENCE: Information on the home is available through the Myford House Care Home Brochure and includes a service users guide. The brochure was reviewed in February 2006 but requires further revision to include the relevant information as described in Schedule 1 of the Care Homes Regulations 2001. Three case files were selected for inspection and included the case file of the person most recently admitted to the home. A pre admission assessment of care needs is undertaken by a senior member of staff prior to the person moving in and is based on the activities of daily living. Additional information is obtained and on file from the local hospital and funding authority. Visitors spoken with confirmed that they were able to visit the home prior to their relative making the decision to move in. Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 9 The home does not offer an intermediate care service. Myford House Nursing And Residential Home DS0000022260.V297443.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 7,8,9,10 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Each resident has a care plan. The plan in most cases includes the information necessary to plan the individuals care, some omissions of recording information may have the potential for not fully meeting a persons needs. EVIDENCE: The acting manager explained that all care plans are currently being reviewed by senior staff with a new system of recording and monitoring a person’s health, personal and social care needs. The revised care plan documentation focuses on the problem – actual/potential, the aim and the care/nursing interventions required. One case file inspected had been completed using the new recording system and included an in depth assessment of need. Risk assessments and monitoring tools being linked to the care plan. A plan for maintaining effective communication for a hearing impairment gave particularly good instructions for staff to follow. The communication plan for a person whose first language is not English was again very informative. The acting manager described the alternate methods for communication in a well-informed way. Pictorial and symbolic boards and Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 11 key phrases had been obtained to assist. One member of care staff speaks Punjabi and offers support with communication. The care plan of a person moving into the home in September 2006 had not been fully completed; the acting manager stated the delay for formulating the plan was due to the revision of the documentation. Nevertheless without an initial plan of care at the point of admission to the home there is no guarantee that all care needs are being fully met. A visitor for this person stated that she is satisfied with the care offered and thought that her relative had ‘settled in well’. The care and treatment of pressure ulcers is recorded in a wound care plan and contained information on the site of the ulcer, and instructions as the type of dressing to be used and frequency of the dressing change. Improvements and/or deterioration are recorded. However the plan had not been reviewed when an improvement was identified, instructions for staff was that the dressing was to be changed alternative days. The date of the dressing change was recorded as 26/09/06 and 03/10/06 an eight day period; the plan had not been updated when the frequency of the dressing change became less. A record was made of the contact with the tissue viability nurse. Monitoring and recording documents have been introduced to record the interventions from care staff and include details of pressure area care and fluid intake and output. The home operates a twenty eight day regimen for the administration of medication using a blister type system with the additional use of bottles and boxes. The midday medication round was observed with the registered nurse and a senior care staff administering the medication to each individual in an appropriate way. The Medication Administration Record was completed at the time of administering the medications. Three trolleys are in used for storing the current mediactions and are kept locked in the main office. Surplus medications, wound dressings and other equipment are stored in the treatment room. It was recommended to the acting manager that an air thermometer be purchased to monitor the temperature of this room to ensure that the medications are stored in line with the Pharmaceutical guidelines. The amount of controlled drugs and quantities recorded in the controlled drugs register accurately corresponded. During the tour of the premises tubs of external creams and lotions were in use, the date of opening had not been placed on the container, it was not possible to establish whether the recommended shelf life had expired. The cultural and gender preferences for helping people with personal care have been addressed and recorded in the care plan at the point of admission. The care staff were observed to be assisting service users with personal care discreetly and in a manner which promotes service users’ dignity. However the lack of locks and ‘vacant /engaged’ signs on communal toilets and bathroom areas meant at times peoples privacy may be challenged when they use these facilities. Myford House Nursing And Residential Home DS0000022260.V297443.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 12,13, 14,15 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The daily living and social activities arranged for residents takes into account the differing expectations, preferences, lifestyle and capacities of each individual. EVIDENCE: The acting manager stated that a member of the care staff has been allocated the additional responsibility of arranging social and leisure activities. Activity records have been introduced and record the type of activity undertaken by the individual. Outside entertainers are arranged and visit the home on a monthly basis, trips to places of interest have been facilitated and in house activities are arranged on a daily basis. One resident confirmed that the ‘entertainers are very enjoyable’ but she also likes to watch the television in her own room particularly when the football is on. Photographs of activities are displayed on the notice board together with details of the functions arranged. Many people were at the home visiting friends and family, and stated that they are always offered a warm welcome when visiting. During the tour of the premises many of the bedrooms were individualised with personal belongings. Staff were observed to be offering choices to residents Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 13 throughout the day, the choices and options very much dependent on the capacity of the individual. The inspector was invited to join residents with the midday meal; the dining room was well prepared in advance, with the meal being presented in an exemplary manner. Staff were observed to be serving and assisting in a relaxed, unhurried and discreet manner. Myford House Nursing And Residential Home DS0000022260.V297443.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 16,18 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. Concerns and complaints are dealt with promptly and professionally with robust procedures and practices in place to ensure that individuals are protected from abuse. EVIDENCE: The home has its own complaints/concerns procedures, a copy of which is displayed at the entrance of the home. Visitors stated that if they had any concerns whatsoever they would not hesitate to see a member of staff and felt confident that their concern would be taken seriously. One resident stated that ‘ if I had any problems at all I would talk to the acting manager’. The acting manager stated that one complaint had been received from a relative recently. This has been referred to the acting managers line manager for investigation and is still ongoing. The daily report in one of the care plans recorded a complaint made by a resident, although this has been investigated and a satisfactory solution offered, the concern was not recorded in a formal way. No complaints have been made directly to Commission for Social Care Inspection since the inspection in March 2006. A copy of the multidisciplinary adult protection procedures is available for staff reference, the acting manager confirming that the homes own policy and procedure for dealing with the protection of vulnerable adults, together with other policies are being reviewed shortly. The home safe keeps small amounts of cash on behalf of some residents for sundry expenditure, the acting manager has revised the procedures and is Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 15 introducing a robust system with the giving and keeping of receipts for each transaction and obtaining two signatures. Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP 19,21,22, 24,25,26 Quality in this area is adequate. This judgement has been made using available evidence including a visit to this service. The service provides a homely environment and has benefited from some redecoration and refurbishment. There are some areas that pose a potential risk to residents, for example, the refurbishment of the kitchen, some radiators are not guarded, and water may be very hot coming from a tap. The timescales for action to reduce the potential risks to residents have not been complied with. EVIDENCE: The acting manager informed of the planned programme for the renewal of the fabric and decoration. The findings of the infection control audit, carried out in February 2006, did confirm that the deterioration of the general condition of the main kitchen posed challenges with regard to food hygiene. Although it was anticipated this work was to be given priority at the last inspection, the requirements are still outstanding. The floor has not been replaced and cannot be cleaned effectively, the kitchen cabinets and units are of a wooden construction, the Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 17 shelves have warped and the melamine is chipped and completely off in places. Priority must now be given to ensure that all areas in the kitchen meet the required standard for hygiene and infection control. Some carpets around the home are showing signs of wear and tear and would benefit from being replaced. The acting manager discussed the plans for the new carpet in the main hall. Consideration should be given to replacing the carpets in the communal areas. Some doors to the private accommodation and communal areas have been fitted with an appropriate door closure that activates to close the door in the event of an emergency. During the tour of the building some doors were being wedged open by wooden blocks or pieces of furniture. If it is a person’s preference to have a fire door open then the appropriate door closures must be installed. One resident who spends much time in bed commented ‘ I like my bedroom as I can look out on the gardens – lots of birds and wildlife’. A private room has been dedicated and allocated for the use of visitors for overnight stays when needed. The room is fully equipped to high standards and provides a very practical and noteworthy facility. The shower facility in the en suite in room 7 is not in working order; the acting manager was unable to state why and was unaware when it will be repaired/replaced. She confirmed that one resident accommodated in the room would benefit from having a shower provision. During the tour of the premises some bedrails have been inappropriately fitted and were not suitable for use. This was discussed with the acting manager who instructed a staff member to undertake a full audit of all bedrails in use to determine their correct fitting and use. The call bell wire in room 2 was trailing from one side of the room to the other where the resident was sitting in her chair; this has the potential of being a trip hazard. The payphone is out of working order, the manager was unable to state when this will be repaired/replaced but stated that a portable phone is available if any resident wishes to use it to make calls. Not all bedroom doors have been fitted with an appropriate locking facility, without this residents do not have a true choice of whether to lock their door or not. Not all bedrooms have been provided with a lockable storage space. The free standing wardrobes in room 11 have not been fixed to the wall and have the potential for toppling over and causing injury to either resident or staff. Some bedside cabinets and bedroom furniture are showing signs of wear and tear and have the potential for splinter injuries. The manager stated that new bed linen has been ordered with some delivered, hand and bath towels were almost threadbare and in need of replacing. Not all radiators in areas accessible to residents have been fitted with a guard or replaced with low surface temperature radiators. This was a requirement following the last inspection in March 2006 and has not been fully complied with. Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 18 Two new boilers for the central heating and hot water have been installed, the hot water outlets were randomly tested, the temperature varied from being cold, lukewarm to hot. The acting manager stated that random testing of the temperatures is carried out on occasions; it is recommended that random selections of outlets are tested on a weekly basis and the temperatures recorded. Hand washing facilities, liquid soap, paper towels and a lidded disposal bin have been provided in the communal bathrooms and toilets, however, in private areas where personal care is undertaken this equipment is not available. All areas must be provided with suitable hand washing facilities at the point of the delivery of care. One sluice disinfector is out of order the acting manager was unable to state when it will be repaired/replaced. The ancillary staff must be commended in maintaining the very high standards of cleanliness observed throughout the home. Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 19 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): that OP 27,28,29,30 Quality in this area is adequate. This judgement has been made using available evidence including a visit to this service. All staff appear to be clear regarding their role and what is expected of them. Residents report staff working with them know what they are meant to do, and that they are generally able to meet their needs. EVIDENCE: At the time of the inspection the acting manager was in charge of the building supported by one first level nurse and five care staff. Catering and domestic staffs are additional. The numbers of care staff are reduced to four during the evening with a further reduction to two at night. One first level nurse is on the premises over the twenty four hour period. Staffing rotas are maintained. The care staff were observed to be generally very busy attending to the needs of residents. The acting manager commented that at times the nurse is extremely busy, as many of the residents require nursing interventions. Consideration should be given to having two registered nurses on duty at peak times. The residents spoken with all made positive comments about all grades of staff ‘ really lovely’, ‘nothing is too much trouble’, ‘staff are very good, they make me comfortable, night staff particularly good and take time to massage my legs when they hurt’. Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 20 Members of care staff discussed the recent opportunities for training to National Vocational Qualification levels 2 and 3 and stated that they enjoyed the course. The acting manager discussed the plans for staff training in core and topic areas for all levels of staff. Two staff personnel files were randomly selected for inspection both contained a completed application form and certificates and records of achievement. One file did not contain any references or a criminal record bureau disclosure. A requirement was issued following the inspection in March 2006 relating to information and documents needed for persons working at the home. Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 21 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): OP 31,33,35,38 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. There is a strong ethos of being open and transparent in all areas of running of the home. The acting manager is resident focused and leads and supports a strong staff team who have been recruited and trained to good standards. EVIDENCE: Since the last inspection in March 2005 the registered manager has left the company. A person has been recruited for the position and been at the home in the acting manager role for three months. A formal application has been submitted to Commission for Social Care Inspection. The acting manager discussed the changes to the service provision implemented since her appointment and detailed the further developments planned. Monitoring the quality of the service provision continues, resident surveys have been distributed in July 2006 but have not yet been audited. Staff meetings are arranged at monthly intervals. Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 22 The monthly unannounced visits by the registered provider or a person within the company are not being conducted on a regular basis as part of the monitoring systems The home safe keeps small amounts of cash on behalf of some residents for sundry expenditure, the acting manager has revised the procedures and is introducing a robust system with giving and keeping receipts for each transaction and obtaining two signatures. Records are kept of the routine testing of the fire alarm, emergency lighting and fire extinguishers. The fire risk assessment for the premises was reviewed and revised in June 2006. The testing for legionella has not been carried out and is outstanding. Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 2 X 2 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 24 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 OP1 Regulation 4(1)(c) Requirement The statement of purpose and service user guide must contain the information as set out in Schedule 1. All residents must have an initial written plan of care at the point of admission to the home or very shortly afterwards. All care plans must be reviewed at least monthly or more frequently when a change of need has been identified. The main kitchen must be refurbished to provide a food preparation area, which can be effectively cleaned and decontaminated, to meet food hygiene regulations. Previous timescale of 23/06/06 not met. All flooring in the home must be clean, in good repair and free from trip risks. Previous timescale of 23/06/06 not met. The registered person must ensure that the appropriate door closures (linked into the fire DS0000022260.V297443.R01.S.doc Timescale for action 01/01/07 2 OP7 15(2)(b) 31/10/06 3 OP7 15(2)(b) 31/10/06 4 OP19 23 (2)(b) 01/01/07 5 OP19 23 (2)(b) 01/01/07 6 OP19 23(4) 01/01/07 Myford House Nursing And Residential Home Version 5.2 Page 25 7 8 OP21 OP22 9 OP24 10 OP24 11 12 OP24 OP25 alarm system) are fitted to doors where there is a need or preference for the doors to remain open. 23(2)(j) The shower in the en suite of room 7 must be repaired/replaced 23(2)(b) All equipment in use must be fitted correctly and fit for purpose Previous timescale of 23/06/06 not met. 23 (2) ( c) All furniture in resident’s bedrooms including bedside cabinets must be kept in good repair. Previous timescale of 23/04/06 not met. 12(4) Doors to service users private accommodation must be fitted with locks suited to service users capabilities. 16(1) All bedrooms must be supplied with a lockable storage space. 23 (2)(p) All radiators in areas accessible to residents must have appropriate guards in situ. Previous timescale of 23/01/06 and 23/04/06 not met 13(3) The registered person must ensure that suitable hand wash facilities are available in all areas at the point of delivery of care. All staff files must contain all relevant recruitment details as per Schedule 2 at commencement of employment by the home. (Previous timescale of 23/01/06 and 23/04/06 not met) The registered person must ensure that a monthly unannounced visit to the home is conducted and a report is available for inspection. The registered person must DS0000022260.V297443.R01.S.doc 01/01/07 31/10/06 01/01/07 01/01/07 01/01/07 31/10/06 13 OP26 01/01/07 14 OP29 19, Sch 2, Sch 4.6 31/10/06 15 OP33 26 01/01/07 16 OP38 13(4) 01/01/07 Page 26 Myford House Nursing And Residential Home Version 5.2 ensure that procedures are adopted for the regular testing of legionella. 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 OP9 Good Practice Recommendations It was recommended that an air thermometer be purchased to monitor the temperature of the treatment room to ensure that the medications are stored in line with the Pharmaceutical guidelines. It is recommended that all external medications be dated upon opening, with tubs of creams/ointments discarded after one month of opening and tubes after 3 months of opening. It is recommended that weekly random checks be carried out to monitor the temperature of the hot water outlets accessible to residents. It is recommended that consideration be given to having two nurses on duty at peak periods. 2 OP9 3 4 OP25 OP27 Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Myford House Nursing And Residential Home DS0000022260.V297443.R01.S.doc Version 5.2 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!