Inspection on 06/08/07 for The Old Lodge Nursing Home

This inspection was carried out on 6th August 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Old Lodge Nursing Home 18/06/08

The Old Lodge Nursing Home 11/02/08

The Old Lodge Nursing Home 24/04/06

The Old Lodge Nursing Home 15/02/06

The Old Lodge Nursing Home 28/09/05

The Old Lodge Nursing Home 15/12/04

The Old Lodge Nursing Home 08/06/04

The Old Lodge Nursing Home 04/11/02

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Old Lodge, The Nursing Home Sandypits Lane Etwall Derby Derbyshire DE65 6JA Lead Inspector Helen Macukiewicz Key Unannounced Inspection 6th August 2007 09:15 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 Old Lodge, The Nursing Home DS0000002135.V340775.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. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Lodge, The Nursing Home Address Sandypits Lane Etwall Derby Derbyshire DE65 6JA 01283 734612 01283 733067 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) Folcarn Limited Vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (5) of places Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 40 Places for OP 5 Places for younger PD aged 50 years and over included in the total above 24th April 2006 Date of last inspection Brief Description of the Service: The Old Lodge is a detached house, which has been adapted and extended to provide nursing care for up to 40 people, aged 65 years and over. However, up to 5 of the bedrooms can accommodate disabled people, aged 50 years and over. The Home is situated in a rural position, approximately a mile from Etwall village centre. The village has several local shops and is on a bus route for Derby. The Old Lodge has 32 single and four double bedrooms across two floors. 10 of the bedrooms have en-suite facilities. Access to the first floor is by stairs or by a passenger lift. The Home has 2 lounges, a conservatory and dining room. The Home also has a well laid out garden. The range of weekly fees is between £487.00 and £560.00 per week. The Inspection reports are made available in the Managers’ office. The Manager provided this information during the Inspection. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was unannounced and lasted 8 hours during one day. 5 preinspection questionnaires were received from people living in the home. Most had been completed with the assistance of a relative or friend. One relatives’ questionnaire was returned. Findings from these questionnaires are included in this report. The Manager had completed a self-assessment of the home and information from this was used in the planning of this inspection. Computer held records of all contact between the Home and the Commission for Social Care Inspection since the last Inspection were also referred to in the planning of this visit. During this Inspection discussion with people who use the service and their relatives took place. Time was spent in discussion with the Manager and staff. Four residents care files were looked at in detail and their care was examined to see how well records reflect care practices within the home. Relevant records belonging to the home were also examined such as complaints and staffing documents. A brief tour of the home took place including some bedrooms. What the service does well: Consideration of the values of dignity and respect is given in the recording of care needs. Relatives/friends consulted during the Inspection offered the following comments about the care given by the home. They look after him beautifully, staff are respectful of his privacy, he has come on really well since he moved here, I am happy with the care, staff keep me informed all the time and I am very happy with the way he is looked after. Comments about the food were all favourable. Relatives/friends said he thinks the food is lovely, he has what he wants anytime and mum thinks the food is great, I have seen the staff offering a choice. Residents also said they found the food satisfactory, one resident said the food is good. Relatives/friends offered the following comments the best thing about this place is its clean and homely and when we chose this home we noticed it had no smell and it was clean, our relative has a lovely view from their window. Comments from relatives/friends included the staff here are brilliant and friendly and the staff are lovely, they are really good and friendly. One resident said communication is very good, the staff are wonderful. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Old Lodge, The Nursing Home DS0000002135.V340775.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 Old Lodge, The Nursing Home DS0000002135.V340775.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): Standard 3. Standard 6 does not apply; the home does not offer intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their advocates have sufficient information to enable them to choose a home that will meet their needs. EVIDENCE: The Manager has updated the written information about the home that is provided to all current and prospective residents and their relatives. The two main documents are the Statement of Purpose and the Service Users Guide. The Manager printed off a copy of the Service Users Guide. This contained a summary of what people can expect from the home and some terms and conditions of accommodation. This did not include details of the total fee Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 9 payable in respect of the service and the arrangements for payment of the fee inlcuding charges for any extras. The Manager confirmed that she has given all residents a copy of the updated versions. Information in residents care files supported that their needs are assessed prior to their admission and the Manager has introduced a new form to use which allows for a comprehensive assessment of need, this had been largely completed in one of the more recent files. Relatives/friends who were consulted during this Inspection confirmed that they had sufficient information to enable them to make an informed choice about whether to send their relative/friend into the Home to live. Old Lodge, The Nursing Home DS0000002135.V340775.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): Standards 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents receive the privacy and care they need although gaps in the management of medicines leaves them vulnerable. EVIDENCE: Residents care files all contained a plan of care that was evaluated regularly. Consideration of the values of dignity and respect was given in the recording of care needs. Although the plans of care made reference to consultation with residents and their relatives, there was no written agreement to the care plan, or for use of specialist equipment. There was evidence in most care files of risk assessments in the areas of nutrition, continence, moving and handling and skin condition as well as general risks occurring within their immediate environment such as risk of scalding when bathing. Some of these were subject to regular reviews. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 11 Care files demonstrated regular involvement and liaison with multi disciplinary professionals within the community such as G.Ps, chiropodists and dietician. Relatives/friends consulted during the Inspection offered the following comments about the care given by the home. They look after him beautifully, staff are respectful of his privacy, he has come on really well since he moved here, I am happy with the care, staff keep me informed all the time and I am very happy with the way he is looked after. All confirmed that staff respect the privacy of the residents. One resident said anything you want - its there. Most medications are given out by staff although some residents do selfmedicate. In one residents room their medication had been left on the bed table. This room was unlocked making it accessible to other residents. The resident did not have a risk assessment or written agreement for selfmedicating in their care file. There are no suitable lockable storage facilities within residents bedrooms for the storage of medicines and bedrooms do not have door locks. This means that although residents right to self-medicate is upheld by the home, there are no arrangements in place to ensure they can do this safely. Records of medications administered by nursing staff were recorded well, although the amount of medicines received into the home was not always recorded on the MAR (Medication Administration Record). Not all staff are using the coding system when a medication is not given for a specific reason. Both these factors make it difficult to establish exact stocks of medications to ensure they are being administered correctly. One medication had expired. One medication that had been discontinued was still in the medicines cupboard. There was incorrect storage of some medications due to the fact that the stock cupboard is not large enough. Some of the residents had barrier creams in their bedrooms, not all of these had been purchased for general use, some had a prescription label removed and a name written on by staff. Others had no date of opening recorded and some had no name on. Old Lodge, The Nursing Home DS0000002135.V340775.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): Standards 11 to 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to make choices about their lifestyle although recreational activities do not meet individuals expectations. EVIDENCE: Some of the care files contained a plan of care to meet social needs and some residents had been asked what their individual routines and preferences are. However, this was not the case for all. Some care files supported that residents are offered choices about their daily life and the Manager was able to provide examples where the home has responded to individual requests such as to change bedrooms. Relatives/friends offered the following comments we visit anytime, he has lots of visitors, the vicar comes in, he is well dressed when I visit, they look after him really well and his hair is always tidy and she has a choice, she likes to choose her clothes, her hair looks nice. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 13 One visitor confirmed that their relative goes out to a day centre. Another confirmed that the staff will allow residents to use the homes telephone in privacy if they need to contact anyone. Some residents had telephones installed in their bedrooms. Residents said they had enough choice about how they spend their time and can opt to spend time in their bedrooms and eat meals in their bedrooms. They confirmed that there is a choice of rising/retiring times, this consistent with the written information about the home contained within the Service Users Guide. Relatives/friends thought that the home offered activities but said this was an area for improvement. Relatives/friends comments included what he needs is more mental stimulation and could do with more activities - thats the only thing. Residents said they would also like to go out more. One resident confirmed that the vicar comes to take Communion but they would love to go out to church. Another said they would like to go out by themselves with one member of staff, another said they would like to go out on group trips, like they did last year. The Manager confirmed that although some activities are provided in the home, there is no member of staff employed to undertake activities and that there have been no trips outside the home this year. Comments about the food were all favourable. Relatives/friends said he thinks the food is lovely, he has what he wants anytime and mum thinks the food is great, I have seen the staff offering a choice. Residents also said they found the food satisfactory, one resident said the food is good. Old Lodge, The Nursing Home DS0000002135.V340775.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): Standards 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents and their advocates are able to express their concerns although gaps in documentation and procedure means they are not fully safeguarded. EVIDENCE: Residents and relatives felt they could complain if they have any problems. One relative said they had raised issues about minor things and they had been sorted out quickly. Another said I can see the Manager anytime and raise things. One resident said they had no complaints and had been happy since the day I got here. There has been 1 complaint raised with the Commission for Social Care Inspection and 4 raised with the Home since the last Inspection. The Manager said these had all been resolved. However, although complaints records described the concerns and action taken by the Home, they did not state the outcome or any actions required as a result of the concern. The Manager confirmed that there have been no safeguarding referrals since the last Inspection. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 15 The residents care files showed that some residents require equipment that carries a degree of restraint such as bed rails and tilting chairs to ensure their safety. However, there was no evidence of a formal assessment of need by a multi-disciplinary team and consent from the resident/advocate for the use of these. In one file there was a suggestion that the persons advocate may not be able to provide them with the level of advocacy required to make such a decision. In another care file the use of a tilting chair was not documented as a required intervention in their plan of care. Old Lodge, The Nursing Home DS0000002135.V340775.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a homely environment that is suited to their needs. EVIDENCE: There has been some expenditure within the environment since the last Inspection. Some of the bedroom carpets have been replaced and a new television has been purchased for the first floor lounge. One member of staff said that there is a plan to purchase more height adjustable beds. Some of the bedroom furniture was worn, some bedside cabinbets had the trim missing and some furniture was badly chipped. Residents said that they felt that some of the furniture did need to be replaced. Some of the carpets had also become quite worn and stained. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 17 Relatives/friends felt the home is clean and some offered the following comments the best thing about this place is its clean and homely and when we chose this home we noticed it had no smell and it was clean, our relative has a lovely view from their window. Most bedrooms seen were homely in appearance and contained residents personal possessions and photographs. All residents who were consulted said they liked their bedrooms and had made them homely. It was noted that none of the bedrooms have door locks or lockable space within them for residents to keep their possessions safe. Whilst general areas of the home were clean and tidy and low level cleaning of bedrooms was evident, observation of the upper parts of bedrooms showed these required cleaning. Some of the wheelchairs belonging to residents also needed cleaning. The Manager confirmed that there is only 1 cleaner and that additional cleaning hours were required to ensure more thorough cleaning of all areas of the home. There is a laundry service Monday to Friday and there were no complaints from residents or relatives received about the laundry. However, it was reported that there is no laundry staff on duty at weekends so there is an accumulation of dirty laundry over the weekends which is stored in the laundry room. It was also reported that there is an open soak away in the laundry due to a blockage which occurred about 5 weeks prior to this Inspection. This matter was reported to the Manager during this Inspection, for her action. The systems for handling laundry were hygienic and staff had access to protective clothing. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 18 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): Standards 27 to 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are cared for by staff who are largely trained to meet their needs although perceived gaps in care suggest numbers of staff and training may not be sufficient to ensure all needs are met. EVIDENCE: Staffing numbers identified on the staffing rota suggested that during the week adequate numbers of staff are usually planned. This was supported by the comments of most residents and their relatives. Staffing levels decrease during the weekend when there is only 1 qualified nurse covering each shift, although the dependencies of residents do not decrease during that time. There were shortfalls on the staffing rotas recently due to the fact that three members of staff had been given authorisation to take annual leave at the same time. The planning of staffing is mostly based around numbers of residents rather than the dependencies of residents, although payments can be made on an individual basis so that one to one care can be maintained where needed. Residents commented that they have to wait some length of time for their call bells to be answered, this was reported to occur mainly during the evenings. Some comments from residents suggested that the attitude of staff can vary, and that at times they felt that their individual care needs were not all met. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 19 One of the relatives who gave feedback also felt that more staff are needed to ensure one to one care needs are all met. The Manager confirmed that only 6 care staff have not yet qualified to National Vocational Qualification level II and that two of those are working towards this. The Home is registered with ‘Skills for Care’ who are assisting the home to source training. The Manager and a qualified nurse were able to confirm that training has been attended by staff although there was no clear training plan that would show which staff required training at a glance. Staff said they have received training in some mandatory areas such as Basic Food Hygiene and Fire Safety but not all had received safeguarding training. The staff are given an induction when they first commence employment. The induction pack is comprehensive and is based around Leicestershire Social Care Development Group common induction programme. The Manager confirmed that staff usually take 6 weeks to complete this and then progress on to National Vocational Qualifications. Comments from relatives/friends included the staff here are brilliant and friendly and the staff are lovely, they are really good and friendly. One resident said communication is very good, the staff are wonderful. Access could not be gained to staff recruitment files on this occasion. However, the Manager was able to talk through the recruitment process and confirmed that staff are appointed subject to obtaining 2 references and a police check. She described safe recruitment processes. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 20 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): Standards 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is efficiently run by a competent Manager in the interests of residents although poor health and safety management leaves residents at risk. EVIDENCE: The Manager is yet to be registered with the Commission for Social Care Inspection although she is an experienced and qualified person. She attends training relevant to her role. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 21 The Manager has sent out questionnaires to gain residents and relatives views about their care. She has not yet been able to action some of the points raised, such as requests for more social activities due to staffing constraints. The Home does not handle money on behalf of residents but have the facilities to do so if required. Relatives/friends confirmed this to be the case. Risk assessments of some areas within the environment that directly affect individual residents were seen in care files. However, further matters relating to Health and Safety required attention:• • • • • • • • Some germicidal bathroom cleaner and two aerosol deodorisers were left unattended in toilet areas, these should be safely stored. It was noted that one of the first floor windows could open wide enough to allow a person through, causing a falls hazard. The carpet in one room identified to the Manager was uneven and frayed causing a possible trip hazard. There are 3 steps leading to the laundry, which could be a potential falls hazard. There are steps leading from the patio outside the dining room, these have not been subject to risk assessment. Some jugs for the collection of urine were stored in toilet areas and were not labelled for individual use. The sluice on the ground floor was unlocked with the door open and this contained both fouled laundry and soiled waste. The kitchen was warm and the door had been left open for ventilation, this did not have a fly screen and there was a large number of flies in the kitchen and food store. The fly net used to cover food had become worn and contained holes large enough to allow insects through. There is no risk assessment of the general environment at the home • The fire officers last report identified some actions required to make the home safe. The Manager verbally confirmed that remedial action has been taken in relation to this. Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 22 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 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 1 Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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 5(1)(bb)( bc) Requirement The service users guide must contain details of the total fee payable in respect of the services and the arrangements for the payment of the fee. Also, the arrangements in place for charging and paying for any additional services. Care plans must document evidence of service users/representatives involvement and agreement to their plan of care. There must be safe arrangements in place for people who wish to self-administer their medication. Staff must record the amount of medicines entering the home and use an accepted coding system when medicines are not given for a specific reason. There must be adequate storage facilities for medicines. Prescribed topical creams must not be re-dispensed for use by another resident. All topical Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 24 Timescale for action 30/09/07 2. OP7 12(3) 30/09/07 3. OP9 13(2) 30/09/07 creams must be dated and labelled. Medications that have expired or are no longer required must be removed from the home. There must be activities planned that meet residents needs. Any equipment that carries a degree of restraint must only be used following a full assessment of need, regularly reviewed and documented with consent in the service users plan of care. To ensure service users are safeguarded and that regard to the Mental Capacity Act has been given. There must be sufficient staff to ensure all care needs can be met. The system for planning numbers of staff must take into account the dependency levels of residents at all times. Staff must receive training appropriate to their role to ensure they safeguard service users and provide them with the care they require. All potential hazards arising from the environment must be identified and so far as practicable removed. A comprehensive risk assessment of the environment must occur. All areas of the home must be kept safe from hazards. 4. 5. OP12 OP18 16(2)(n) 13(7) 30/09/07 30/09/07 6. OP27 18(1)(a) 30/09/07 7. OP30 18(c) 31/10/07 8. OP38 13(4) 30/09/07 Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 25 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. 3. Refer to Standard OP12 OP16 OP19 Good Practice Recommendations Social need should be included in any plan of care, and these should also include a record of any individual needs and preferences. Complaints records should state the outcome or any actions required as a result of the concern. Replacement of worn items of furniture and carpets should occur. Bedrooms should have a lockable space for residents to keep their possessions/medications safe. Residents should all be given the option of a lock for their bedroom door, subject to risk assessment. There should be sufficient staff employed to ensure that high dusting and cleaning of resident’s wheelchairs occurs. The home should ensure all staff training needs are identified through a training plan. The Manager should complete her registration with the Commission for Social Care Inspection. 4. 5. 6. OP26 OP30 OP31 Old Lodge, The Nursing Home DS0000002135.V340775.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 - 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. 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