Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Oak Lodge Nursing Home 514 Bury New Road Prestwich Manchester Lancashire M25 3AN The quality rating for this care home is:
one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jenny Donnelly
Date: 1 2 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home
Name of care home: Address: Oak Lodge Nursing Home 514 Bury New Road Prestwich Manchester Lancashire M25 3AN 01617980005 01617735572 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Mavis Birkenshaw Type of registration: Number of places registered: Dr Kumar Shamroa Kotegaonkar,Mr S R Latimer care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Oak Lodge is a care home providing nursing and personal care for older people. It is a large detached converted house and is situated on the main bus routes leading into the centre of Bury, Prestwich Village, Salford and Manchester. There is nearby access to the motorway network. The home is very close to supermarkets and shops. The main door at the front of the home and the conservatory allow level access for wheelchair users and people who have problems climbing steps. The home is registered to care for 41 residents and provides accommodation in mainly single bedrooms on the ground and first floors. The bedrooms on the first floor are reached either by stairs or passenger lifts. There is a large lounge area to the side of the home and in front of this is the conservatory. This looks out onto a small garden area. There is also a large dining room and at the far end of this, there are two small, but bright sitting rooms. Care Homes for Older People Page 4 of 28 0 Over 65 41 Brief description of the care home The toilets and bathrooms have aids to assist people with a disability or mobility problem. The home runs a Rapid Response service, which provides urgent short term nursing care for people who do not necessarily require admission to hospital. The weekly fees at the time of inspection ranged from £404 to £512, according to care needs. Some people in receipt of Rapid Response or Continuing Care had individual fees in accordance with their health needs assessment. Additional charges were made for private chiropody, hairdressing and newspapers. Written information about the service and the fees charged could be obtained from the care home along with copies of inspection reports. Care Homes for Older People Page 5 of 28 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was the key inspection of this service for the year. Jenny Donnelly and Marian Whittam, inspectors, made an unannounced visit to the service between the hours of 09.00 and 16.00 on the 12th November 2008. During this visit we (the commission) toured the building, spoke with people who live in the home, with staff and the manager. We looked at care, staffing and management records. We saw how people were spending their day and saw lunch being served. Both Dr Kotegaonkar and Mr Latimer, the home owners called in during the day, and their external consultant was present throughout the inspection. Earlier in the year the manager had completed and returned an Annual Quality Assessment Audit (AQAA) that we had requested. The AQAA is a self assessment Care Homes for Older People
Page 6 of 28 document that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information. What the care home does well: What has improved since the last inspection? Since the last inspection the home has had considerable work done to improve the environment. The carpet on the ground floor had been replaced with non slip wood look flooring, which looked clean and fresh. A number of the windows to front of the building had been replaced with double glazed units. Several bedrooms had been decorated and provided with new lighting, and this was planned to continue throughout the home at one bedroom a month. Two new large flat screen televisions had been purchased, and a new large passenger lift had been installed that was easier for people to operate by themselves. New lounge armchairs had been tried, tested and ordered, and new dining room furniture was to be purchased next year. Care Homes for Older People Page 8 of 28 A key worker system had been introduced, so each person knew they had a carer dedicated to take a special interest in them. Staff had received training in palliative care and safeguarding vulnerable adults, and plans were being made for further training. Three staff had attended training in staff supervision and a formal supervision programme had been put in place. Staff recruitment processes had been tightened up and new staff had undergone thorough checks before starting work, to make sure they were suitable to work with vulnerable people. The management team had been strengthened by the appointment of an operations manager, who was supporting the registered manager with administrative tasks and overseeing the refurbishment works. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was good written information for people about the services and facilities offered at Oak Lodge and the admission process helped people be confident the care home would be able to meet their care needs before they moved in. Evidence: The service had produced a statement of purpose and service user guide, which detailed the services and facilities provided at Oak Lodge. The guides contained all the information required under the care home regulations. The operations manager was in the process of updating the management structure in this, to include her own role. Copies of these documents were not out on display in the home and the manager agreed to make them more easily available to people. New people were only admitted to the care home following a comprehensive assessment of their needs. We looked at the assessments of three people including a
Care Homes for Older People Page 11 of 28 Evidence: person newly admitted for long term care, a person with complex nursing care needs, and a person receiving short term rapid response care. In all cases the manager, or senior nurse, had completed an assessment of the persons health and personal care needs. The service had also gathered information from other relevant professionals, including doctors, hospital staff and social workers. Some people also had assessments from other agencies on file. The admission process helped people to know if the care home would be able to meet their individual needs before they moved in. It also enabled staff to draw up an initial plan of care for the person and to have ready any specialist equipment they needed. People told us they, or their families, had been able to visit the care home to look around. Some people had already been to the home for a short stay under the rapid response scheme before choosing to move in permanently. Care Homes for Older People Page 12 of 28 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were receiving good quality personal care that was delivered in accordance with their individual needs. There was some poor practice in the way medicines were handled, which could place people at risk. Evidence: Individual care plans were in place for each person and we studied three of these closely. The plans were detailed and provided staff with clear instructions on what level of support people needed. Where nursing interventions were required, such as the management of a tube feed into a persons stomach, the feed regime and instructions on caring for the tube were clearly documented. Risk assessments had been completed to ensure peoples nutritional needs, skin care and moving and handling needs were being safely managed. We saw instructions were in place for people with specialist dietary needs, and their weight was monitored regularly. People with fragile skin had specialist mattresses and seat cushions provided, and those with moving and handling needs had been assessed
Care Homes for Older People Page 13 of 28 Evidence: for the appropriate type of hoist. The care plans and assessments had been kept under regular review and updated as peoples needs changed. People had good access to general health care such as their doctor, optician and the dentist. Some people also received input from specialist services such as the diabetes nurse, occupational therapist, physiotherapist and rapid response team staff. We spoke with members of the rapid response team, who told us that the service was effective in avoiding hospital admissions for people, and staff were good at following their instructions and guidance. We saw that for short stay people, there was good planning in place to safely manage their return home. People had been allocated a key worker which is a carer assigned to work primarily with the same small group of people. This system had only been operating since September and appeared to be working well. We saw how staff were caring for people in the lounge and dining rooms. Staff were explaining what was happening and not rushing people. We saw hoists being safely used and noted that people were being reassured during the process. We saw that staff maintained peoples dignity by ensuring their clothing remained in place whilst they were being hoisted. The general talk between residents and staff was pleasant, friendly and polite. People told us they were very well looked after here. The service had written procedures for end of life care and a number of staff had attended training in death and dying. The home had information on NHS care pathways, including pain management and symptom control. We spent some time looking at the way in which the service handled peoples medication, and observed one of the nurses administering the lunch time medicines, which she did safely. There were written policies and procedures to guide staff in medicines management and other reference materials including the Royal Pharmaceutical Society guidance for care homes. Medicines and printed administration charts were supplied monthly by a local pharmacy. There was a record of all medicines received into the home and the administration records for ordinary medicines had been accurately completed. We audited the ordinary medicines for three people and found no discrepancies in their records or the amount of medicines remaining in stock. Blood thinning medicines prescribed in relation to blood test results, had been accurately managed. Contrary to the homes own procedures and Royal Pharmaceutical Society guidelines, the service did not keep any records of medicines they disposed of. Waste medicines were rightly being taken away by a licensed contractor, but there were no records of what had been disposed of, and the service must be able to fully account for what they
Care Homes for Older People Page 14 of 28 Evidence: have done with peoples own medicines. We checked the amounts and records for medicines which staff treated as controlled drugs. These medicines were securely stored and a record book was kept and signed by two staff for each administration. However, in two cases we found large discrepancies between the amount of medicine in stock and the records. In one case there was more medicine left than there should have been, and in another care there was not enough left. This indicates that people could have been given more, or less, of these strong painkillers than they were supposed to have. The handling of controlled drugs must be accurate to ensure people get the right medication, and to safeguard staff against any accusation of misuse of these strong drugs. We made good practice recommendations that products with a short shelf life, such as eye drops, should be marked with the date of opening to ensure they are still effective when given to people. Insulin pens should be name marked, to prevent any mix up, as two people used the same type of pen, which were pre set to different doses, and could lead to the wrong amount of insulin being given. Where medicines were prescribed in variable doses, such as one or two tablets, it should be clear how many were given, so staff know when the person has reached the maximum daily dose. A regular system of formal medicine audits would help the service to manage medicines more robustly. Care Homes for Older People Page 15 of 28 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care home had a flexible routine which enabled people to choose how to spend their day. People living in the home were provided with a good range of activities and a variety of food that met their needs. Evidence: People told us they were able to spend their days as they wished, either using the public lounges or remaining in their own bedrooms. When we arrived in the home at 9 am only a small number of people, who liked to rise early, were up and dressed. Staff said the majority of people chose to have their breakfast in bed, or sitting up in their bedrooms, and people later confirmed this to be correct. An activities organiser visited the home for two afternoons each week to chat with people, look at newspapers and do quizzes. There were visiting entertainers every three months, comprising of musicians and singers. Some of the people we spoke with really enjoyed these events, while others said they preferred, and were able, to stay in their bedrooms. A number of people enjoyed reading and had access to daily newspapers and library books. The home celebrated special occasions, and we saw a Remembrance Day display in the entrance hall. The hairdresser visited twice a week
Care Homes for Older People Page 16 of 28 Evidence: and people said they looked forward to that. The Roman Catholic priest visited the home every month, and other clergy came to visit individual people on request. The home had an informative coloured newsletter, which was produced quarterly by one of the residents. People living in the home were very proud of this and of their contributions to it. People told us their visitors were made welcome in the home and they could see their them in any of the public rooms or in their bedroom for privacy. There were a number of small public rooms where people could see visitors without being disturbed. The home operated a four week menu that had been drawn up in consultation with a qualified nutritionalist to ensure the nutritional content and portion sizes were suitable. A cooked breakfast was available at weekends, there were two choices of main dish at lunch time, and hot and cold choices for the evening meal. The menus included some regional dishes. People told us they made their menu choices one day in advance, and the weeks menus were on display. We observed lunch being served, and saw that meals were individually plated in the kitchen according to the order sheet and served immediately. People enjoyed their lunch and told us the meals are always good, and there are two choices everyday. People were talking about the Christmas day menu saying Christmas here is always lovely. The cook catered for any special dietary needs and had a record of these in the kitchen. We saw the kitchen was tidy and well organised, with food products suitably stored. Care Homes for Older People Page 17 of 28 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People knew how to complain and felt confident that staff would listen to, and address, their concerns. Staff were aware of their responsibilities to protect people and keep them safe. Evidence: The service had a complaints procedure, which was on display and told people how to raise concerns and the timescale in which to expect a response. The service recorded any complaints received but used two systems to do this, and the operations manager was intending to streamline this. There had been one complaint in the last year which the service has responded to appropriately. People we spoke with told us they knew how to complain if they needed to and felt confident the matter would be addressed. People confirmed that senior staff were always around and available to listen to them. One person said, this is a safe place, there is no cruelty here. Several staff had attended training on safeguarding people from harm, and this training was being cascaded to the remaining staff. The staff we spoke with understood the principles of safeguarding and were aware of how to report any concerns or allegations to the appropriate authority. Care Homes for Older People Page 18 of 28 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean comfortable home that is benefiting from extensive refurbishment. Evidence: Oak Lodge is an older property that has been extended and modernised to make it suitable as a care home. There is on site parking and ramped access to the front door. The home has spacious lounge and dining areas, with a number of smaller sitting rooms and conservatories. There are two shower rooms and three baths, two of which are assisted baths. There are plenty of toilets situated near to the bedrooms and living space. The home is registered for 41 people, but due to double bedrooms rooms now being used as singles, they accommodate 38 people. Bedrooms vary in size and shape and were comfortably furnished, and some had been nicely personalised by people. Three of the bedrooms had en suite facilities. The home was equipped with hoists, and there were 14 electric profiling beds, and other equipment to help people with mobility problems. There were lifts to the upper floors. The home was clean and fresh smelling, and there were housekeepers going about their duties throughout the day. Personal laundry was done on site, with bedding and
Care Homes for Older People Page 19 of 28 Evidence: towels being contracted out to a professional laundry service. Peoples clothes were nicely laundered. There were good infection control arrangements in place, and plenty of hand washing facilities for staff. However, the home did not have a sluicing disinfector, and commode pots were rinsed using a shower attachment that causes spray and possible spread of infection. It is recommended that a sluicing disinfector be provided to safely wash and sterilise equipment. During the last year a lot of refurbishment has taken place in the home. New wood look flooring has been laid throughout the ground floor corridors and living spaces. Many of the windows at the front of the building have been replaced with PVC double glazed units. Two large flat screen televisions had been purchased. Bedrooms were being decorated one each month, and some new lighting had been provided. New lounge armchairs were on order and there were plans to renew the dining furniture in the next financial year. The equipment being stored in the main bathroom was to be transfered into secure external storage sheds that were about to be purchased. A new larger passenger lift had been installed, that was easier for people to operate by themselves if they wished to. Bedroom doors still did not have locks fitted although a recommendation has been made on this previously. The manager said people are asked if they want a lock but there is no record of this. It is recommended that peoples decision on this be recorded. Care Homes for Older People Page 20 of 28 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were happy they were cared for by a competent and caring team of staff. Evidence: Oak Lodge was suitably staffed to meet peoples care needs and ensure the smooth running of the service. There was one nurse on duty at all times, plus the registered manager during week days, supported by six carers during the morning, five in the afternoon and two at night. There was also the operations manager who provided administrative support, plus catering, housekeeping and maintenance staff. Staff were supported to complete National Vocational Qualifications (NVQ). Nine care staff had completed an NVQ in care, and four were working towards this, giving the service a total 65 of care staff with an NVQ, which is good. Five of the housekeeping staff and the cook were also working towards gaining NVQs in their areas of work. We looked at the files of three staff new to the service this year. The files showed that all necessary pre-employment checks had been completed prior to people taking up post, to make sure they were suitable to work with older people. These checks included criminal records bureau (CRB) checks and references. They had obtained a CRB in respect of one person, that was outstanding at previous inspections. They had also started to keep brief interview notes when appointing new staff. Care Homes for Older People Page 21 of 28 Evidence: All new staff underwent induction training organised through the Bury Training Partnership. The induction consisted of a 12 day programme which covered all aspects of care and health and safety. The operations manager had started to draw up a matrix of all staff training, so she could plan future training and refresher courses as needed. There was evidence that staff had been able to access some training this year including end of life care and protection of vulnerable adults. There were training sessions planned for infection control, food hygiene and person centred care. Health and safety training was out of date for some staff, and this is reported under the Management and Administration section of this report. People told us the staff were very good, and that everyone is kind and friendly. We saw that staff worked well with people and created a warm and welcoming atmosphere in the home. Care Homes for Older People Page 22 of 28 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was being managed in the best interests of the people living there, and the strengthening of the management team had a positive impact on the overall running of the service. Evidence: The registered manager is a registered nurse with extensive experience, who has worked at Oak Lodge for 20 years. The manager does not hold any management qualification and feels she is too near to retirement to undertake this now. The registered manager is supported by the two owners of Oak Lodge, an external consultant and the newly appointed operations manager. The operations manager had just started NVQ level 4 in management, and they were considering putting one of the nurses forward for management training. There were a number of quality checks in place. The owners of the service visited regularly and provided written reports which included information gained from
Care Homes for Older People Page 23 of 28 Evidence: discussion with people who live in the home and staff, and about any environmental issues. A room by room audit had been completed of the building, which listed any repairs, redecoration or new items of equipment or furniture needed. The findings were included in the financial planning for the home. The operations manager and registered manager had a visible presence in the home and talked with people regularly to gain their views. People we spoke with confirmed that this was the case. The service sought feedback from visiting professionals and relatives in the form of surveys. The surveys were not given to the people living in the home and the operations manager agreed to do this. The manager held money on behalf of some people for safekeeping. We looked at the way this was managed and although individual records were held for each person, the actual money was pooled into one cash tin. Peoples money should be held separately so that it can be checked and audited. The operations manager said the current system was difficult to audit and she was looking for a different way to manage this. Further to a previous inspection requirement, the service had recently implemented a staff supervision process. Three senior staff had completed a training course on supervision and contracts and recording tools had been devised. A matrix was in place showing the planned supervision sessions and we saw that some had already taken place. Supervision included discussion on care practices and training needs, which would feed into the overall training plan. We saw evidence that the homes equipment and services had been checked to ensure everything was in safe working order. Checks had been made on the water supply, fire preventions, electrical and gas safety. These checks ensured there were safe working and living conditions for people who use the service and the staff. We noted that fire training for staff had last taken place in March 2007 and was overdue. Fire training was provided by an external contractor and the operations manager agreed to make arrangements for this urgently. Moving and handling training for some staff was also overdue, and the operations manager agreed to check with their in house trainer to see if the records were up to date. During our observations throughout the day, we did not see anything that concerned us in the way staff helped people to mobilise or in the way the lifting equipment was used. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 Accurate records of the receipt, administration and disposal of controlled drugs must be maintained. To ensure that medicines subject to the Misuse of Drugs Act are safely managed and fully accounted for at all times. 31/12/2008 2 9 13 All medicines and the 31/12/2008 quantities disposed of by the service must be clearly documented. From the services records it should be possible to account for all medicines the home manages for people to make sure they are properly handled. 3 38 24 All staff must receive 31/12/2008 training in fire prevention, and the action to be taken in the event of a fire occurring. This is to reduce the risk of fire and so staff can be Care Homes for Older People Page 26 of 28 aware of the correct procedures should a fire occur. Recommendations
These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 It is recommended that where variable doses of medicines are prescribed, such as one or two tablets, staff record how many were given, so they know when the person has been given the maximum dose. It is recommended that insulin pens be named so staff can tell which pen belongs to whom, and prevent possible mistakes being made. It is recommended that medicines with a short shelf have the date of opening marked on them, so that staff know they are in date and effective for the person taking them. It is recommended that people should be given a choice of whether they wish to have a lock fitted to their bedroom door and be supplied with the key. A record should be kept of this. It is recommended that the service installs a sluicing disinfector so that equipment can be safely and thoroughly washed and sterilised to reduce risk of infection. It is recommended that where the manager holds money for people, this should not be pooled together, but held separately so that regular checks and audits can be carried out. It is recommended that all staff receive annual moving and handling training to safeguard themselves and any people they handle from injury. 2 9 3 9 4 24 5 26 6 35 7 38 Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 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!
