Inspection on 02/08/05 for Oldfield Bank

This inspection was carried out on 2nd August 2005.

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

Oldfield Bank 30/07/07

Oldfield Bank 12/09/06

Oldfield Bank 21/12/05

Oldfield Bank 26/01/05

Oldfield Bank 20/07/04

Oldfield Bank 26/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Oldfield Bank 5 Highgate Road Altrincham Cheshire WA14 4QZ Lead Inspector Val Bell Unannounced 02 August 2005 06:00 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 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. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Oldfield Bank Address 5 Highgate Road Altrincham Cheshire WA14 4NG 0161 928 0658 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Anne Leavy Mr Lawrence Leavy Mrs Anne Leavy CRH Care Home PC Care home only 28 Category(ies) of OP Old Age registration, with number PE(E) Physical disability - over 65 of places Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: All service users will fall within the category of old age and may additionally have a physical disability. Date of last inspection 14 February 2005 Brief Description of the Service: Oldfield Bank provides accomodation and personal care for up to twenty-eight residents within the category of old age. Residents may also have a physical disability. Mr Lawrence and Mrs Anne Leavy own Oldfield Bank with Mrs Leavy being the registered manager. Mrs Leavy is supported by Karen Sykes the deputy manager. The home is a large detached property, which has been extended and is set in pleasant grounds. The enclosed gardens are well maintained and residents can sit or stroll in the grounds. Car parking spaces are provided at the front of the building. The home has 26 single bedrooms, six of which are en-suite. Upper floors are accessed by a passenger lift and stairways. The home is situated within a residential area of Altrincham and is a short distance from shops, transport links and the motorway network. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was started at 6a.m. on Tuesday 2nd August 2005. It was prompted by the receipt of an anonymous complaint made to the Commission on 19th July 2005. There were several elements to the complaint, some of which were upheld during the inspection. These are detailed under the various headings within the report. It was encouraging to note that the manager and provider demonstrated a willingness to address the shortfalls identified in this report. During the inspection the inspector spoke to residents, staff and visitors to the home. A tour of the premises was undertaken and a variety of relevant records were examined. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that all care staff have access to residents care plans and care staff should receive guidance in taking on additional responsibility as part of their development. This could be achieved by offering training in care planning. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 6 The home is required to take professional advice in assessing the physical needs of residents and specialised moving and handling equipment must be available to residents who have an assessed physical need. Additionally, staff must receive training in the use of any specialised equipment provided. The outcomes of the personal care delivered to residents must be recorded on a daily basis. These recordings in daily summary sheets must reflect the assessed needs of residents as detailed in their care plans. The practice of pre-dispensing medication during the night shift was unsafe. The registered person must ensure that medication is dispensed at the point of administration to residents. Although residents described a range of activities provided by the home, this was not supported by written evidence of a structured activity programme. The home did not have a complaints log in place and staff seemed unsure of the correct procedures to follow in allegations of abuse. The number of bed rails in use (11) was a cause for concern. In conversation with staff it appeared that in some cases bed rails had been fitted to prevent residents getting out of bed in case they fell and injured themselves and most of the bedrails had not been fitted with bumper pads, although these were provided by the home soon after the inspection. It was clear that the use of bed rails was a well intentioned attempt to protect the welfare of residents. However, this practice was unsafe and also removed ambulant resident’s rights to freedom of movement. The practice of wedging open bedroom doors had not been risk assessed and the registered person must ensure that an up to date fire risk assessment is in place. The home was not consistently recording all accidents experienced by residents in the accident book. 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. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 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 standard(s) 3, 4 and 6 Information about the home is clear and concise and is used by prospective residents to help them choose a home that is right for them. The home paid attention to detailed assessments of residents physical and healthcare needs to ensure that the service they provide would meet resident’s needs. EVIDENCE: Care manager assessments of need had been obtained prior to making a decision on whether to admit a person into the home. From examination of residents’ records it was apparent that comprehensive assessments of need had been undertaken by the home in determining if a prospective resident’s needs could be met. In conversation with residents it was confirmed that the home had arranged for them to visit prior to admission. Relatives also confirmed that this was correct. This usually consisted of an afternoon visit including a meal taken along with the permanent residents. Residents’ relatives also confirmed that comprehensive information had been provided prior to admission. The home did not offer an intermediate care service. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8, 9 and 10 The content of care plans was good. However, improvements were necessary to ensure that all staff had access to care plans. The homes failure to provide specialised moving and handling equipment placed the health and welfare of residents and staff at risk. Unsafe practice in the administration of medication placed the health and welfare of residents at risk. Residents living in the home were treated with respect and their dignity was maintained by staff. EVIDENCE: A recent complaint received by the Commission had alleged that care plans were not accessible to night staff. This part of the complaint was upheld, as on the morning of inspection the night staff on duty did not have access to care plans, which were locked in the office. A requirement was made for the registered person to ensure that all staff can access care plans and that they are used as working documents. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 10 Care plans contained evidence that residents had access to a variety of health services such as district nurses, chiropody, podiatry, dentistry and opticians. The recent complaint received by the Commission alleged that the home did not have lifting equipment, such as a hoist and this was confirmed during the inspection. It was noted that one of the residents had been confined to bed for several months due to increasing frailty. It transpired that it was the practice for two members of staff to physically lift this resident. This was confirmed in conversation with night staff. The night staff on duty stated that they would physically lift a resident if they fell on the floor. These practices are unsafe and must cease. The home must have this residents moving and handling needs assessed by an appropriate professional and the required lifting equipment must be provided and staff trained in its use. On the morning of inspection (at 6am) there was an ample supply of continence pads, gloves and aprons available. Residents’ diary sheets did not contain enough information to provide evidence that residents’ needs were being met and the format used did not provide enough space to record the required information. Daily diary sheets completed by staff needed to be developed, to accurately record the personal care delivered by staff in accordance with residents’ individual care plans. It was encouraging to note that the manager had developed an appropriate format before the completion of the inspection. In relation to the complaint made this inspection began at 6am in order to assess the medication practice during the night shift. It was alleged that medication was being pre-dispensed on to trays for later administration with resident’s breakfasts. On arrival at the home it was noted that a tray containing plastic pots of medication had been left in the kitchen. Some of the pots also contained a piece of paper with a residents name on. This practice is unsafe. Medication must always be dispensed from the pharmacy packaging at the point of administration to a resident. This element of the complaint was upheld. The inspector observed the administration of medication to residents during lunch and this task appeared to be carried out appropriately. A full audit of the homes medication procedures was not undertaken during the inspection. The Commissions pharmacy inspector will undertake an audit to assess procedures and offer guidance to staff administering medication. The outcome of this will be included in the homes next inspection report. The homes medication trolley was freestanding and had not been securely anchored to the wall when not in use. The inspector had conversations with residents, staff and visitors to the home. Without exception, everyone spoken to confirmed that residents were treated with respect and that staff upheld their right to privacy. Residents praised the Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 11 quality of care in the home. One resident commented, ‘Staff are caring and nothing is too much trouble’. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 and 15 A range of activities had been provided by the home. However, the social care needs and preferences of individual residents needed to be assessed. Visitors are made welcome to the home and relatives are confident that staff will keep them informed of the resident’s progress. Residents’ health is maintained by the provision of a well-balanced and nutritional diet. EVIDENCE: Four residents care plans were examined during the inspection. These needed further development to include social needs assessments, including individuals’ preferences and likes and dislikes. Residents told the inspector that the home provided activities such as a visiting entertainer, manicures, regular quizzes, special celebrations and visits to the home by members of the United Reform Church. Residents also stated that they were able to go out individually with supervision if needed on shopping trips and local walks. At the time of inspection the home was planning a trip to Knowsley Safari Park. A recommendation was made for the home to post a weekly activity schedule on the homes notice board and to record the outcome of all activities provided. A resident, who was a retired musician, was encouraged to continue playing the piano. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 13 The home operated an open visiting policy. During the inspection visitors were made welcome to the home. The daughter of a resident told the inspector that she found staff approachable and was confident that she would be kept informed of her mothers well being. Another visitor told the inspector that staff treated the residents with respect and that privacy and dignity were maintained. A two-week menu rota was in place at the home. The inspector joined residents for their lunchtime meal, which was attractively presented and appetising. During the meal residents stated that they enjoyed the food provided by the home and confirmed that they were afforded choice in their diet. The mealtime was relaxed and staff were on hand to offer assistance to residents if needed. The kitchen and food storage areas were clean and food was being appropriately stored. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 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 standard(s) 16 and 18 The home had a complaints procedure but this required updating into a formalised procedure to ensure that residents concerns were taken seriously and acted upon. The absence of risk assessments that justify the use of bed rails and the staffs lack of awareness of adult protection procedures leave residents potentially at risk of abuse and harm and their right to have freedom of movement and be safe is not protected. EVIDENCE: The inspector was told that all residents had been issued with a copy of the homes complaints procedure on admission. The home did not have a complaints log in place. This must include details relating to the date a complaint is received, the details of the complainant, an outline of the complaint and the action taken by the home. These records must be signed and dated by the member of staff dealing with the complaint. The home was using Trafford Metropolitan Borough Councils policy on the protection of vulnerable adults. However, staff were not able to demonstrate a thorough understanding of the correct procedures to follow in allegations of abuse. It was required that staff receive training in awareness of abuse and relevant procedures. The recent complaint received by the Commission alleged that furniture was being used to ‘barricade’ residents in their beds. The high number of bed rails in use at the home was a cause for concern. Eleven bed rails had been fitted Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 15 and risk assessments for a number of these did not provide clear evidence to support their use. Additionally, it was evident that in addition to bed rails, items of furniture had been positioned at the foot of some beds. This element of the complaint was upheld. In discussion with the manager and deputy it was clear that this was a well intentioned attempt to prevent some residents getting out of bed in case they fell. However, this practice was unsafe and also removed ambulant resident’s rights to freedom of movement. Prevention of falls must not be managed by restricting peoples’ rights to freedom of movement. The registered person must take professional advice in reassessing the need for the use of bed rails with individual residents. An immediate requirement was made for the home to undertake risk assessments on the use of bed rails within 24 hours and to provide bumper pads to all bed rails within 14 days. A further monitoring visit undertaken by the inspector revealed that this had been achieved by the home within the required timescale. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 21, 23, 24, and 26 Residents’ environmental needs were being adequately met in a comfortable and homely way. The practice of wedging open bedroom doors and the absence of an up to date fire risk assessment potentially placed residents at risk of harm in the event of a fire. EVIDENCE: The inspector undertook a tour of the premises and found the home to be clean and hygienic and no unpleasant odours were detected. The décor and fabric of the building were of good quality and well maintained. Some of the residents’ bedrooms were fitted with telephone points and the office phone was available for making private telephone calls. Resident’s rooms were personalised and residents confirmed that they were comfortable and had all the facilities that they needed. The practice of wedging bedroom doors open was in evidence and this had not been risk assessed. The inspector was told that some of the residents had Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 17 requested this, although this had not been recorded in the care plans. All door wedges must be removed. The home is required to consult the local fire officer on this issue. Additionally, the home must develop an up to date fire risk assessment. Communal facilities provided by the home included two lounges and a conservatory. The garden area was accessed via steps or a ramp for disabled access. The attractive and well-tended gardens included a private seating area for residents use. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, and 30 Adequate staffing ensured that residents’ day-to-day needs were met. EVIDENCE: The homes rotas confirmed that staffing had been deployed in sufficient numbers according to the requirements of the previous registering authority. On the day of inspection the cook was on annual leave and the manager was providing the necessary cover. The inspector was told that the home did not employ domestic staff. The manager undertook all domestic tasks within the home. Throughout the inspection staff were observed to be responsive to residents requests for assistance. Staff appeared to have the qualities and experience to meet the assessed needs of residents. Two carers have achieved NVQ level 2 in care. The registered person must ensure that 50 of care staff are qualified to this level by 31st December 2005. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, 36, 37 and 38 Management arrangements were appropriate. However, some elements of practice had the effect of infringing the right of residents to have freedom of movement. Improvements were needed to the recording of accidents. EVIDENCE: The deputy manager runs the home on a day-to-day basis under the supervision of the registered manager. The inspector was told that it is the intention that the deputy applies to become the registered manager. The deputy has almost finished studying for NVQ level 4 in care and the Registered Managers Award. A requirement was made for all staff to be issued with the General Social Care Council Codes of Conduct for Care Staff. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 20 Leadership was in evidence within the home. However, the management team needed to update their practice in relation to ensuring resident’s rights were upheld as detailed elsewhere in this report. Additionally, carers should be developed to acquire the skills to take on more responsibility, particularly in the area of developing care plans and keyworking. It had been alleged by a complainant that the homes accident book was not accessible to staff working the night shifts and that a fall experienced by one of the residents had not been recorded. At the point of inspection the accident book was available to the night staff on duty. However, the incident referred to, had not been recorded in the accident book. This element of the complaint was upheld. The inspector was told that the home did not manage the residents’ finances. This was managed either by the residents themselves or their relatives under power of attorney. The inspector was told that care staff had been supervised every two months and that supervisions were recorded. All other records examined during the inspection appeared to be accurate and up to date and the homes certificate of registration was appropriately displayed. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 4 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 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 2 3 3 x 3 3 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 1 2 2 3 x 3 3 3 1 Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? 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 OP7 Regulation 16 (m) (n) Requirement Care plans must include social needs assessments and a record of individual residents preferences, including their likes and dislikes. All care staff must be able to access residents care plans at all times. Daily progress records must accurately reflect the care delivered as detailed in individual care plans. Residents physical needs must be assessed by a relevant professional and specialised equipment to meet residents assessed physical needs must be provided. Additionally, staff must be trained in the use of all specialised equipment provided by the home. The registered person must ensure that medication is dispensed at the point of administration to residents. The medication trolley must be securely fixed to a wall when not in use. The home must maintain a written complaints log to include all the information required. Physical barriers (such as Timescale for action 02.10.05 2. OP7 15 02.09.05 3. OP8 14 (1) (a) 02.10.05 4. OP9 13 (2) 02.09.05 5. 6. 7. OP9 OP16 OP18 13 (2) 22 13 (7) 02.09.05 02.09.05 02.09.05 Page 23 Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 8. OP18 14 9. OP18 13 (6) 10. OP19 13 (4) 11. OP30 18 12. 13. 14. OP32 OP32 OP38 18 (4) 18 17 Schedule 3 (3) (j) 13 (4) 15. 16. OP18 furniture) must not be used to prevent residents falling or getting out of bed The home must undertake a reassessment to determine the appropriate use of bed rails with individual residents. Staff must receive update training in abuse awareness to include the correct procedures to follow in allegations of abuse. The registered person must consult the fire officer on the use of wedges to hold doors open. Where residents have specifically requested this, it must be risk assessed and kept under regular review. The registered person must ensure that 50 of care staff are qualified to NVQ level 2 (or equivalent) by 31st December 2005. Copies of the General Social Care Council Codes of Conduct must be given to individual care staff. The homes management staff must undertake update training in equal opportunities. All accidents occurring to residents and staff within the home must be recorded in the accident book. Bumper pads must be fitted to bed rails in use at all times. Within 24 hours 02.11.05 02.09.05 31.12.05 02.09.05 02.11.05 02.11.05 16.08.05 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 OP32 Good Practice Recommendations The registered person should consider developing care F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 24 Oldfield Bank 2. OP12 staffs skills in taking responsibility for care planning. The home should provide written evidence of a structured activity programme for residents. Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Oldfield Bank F55 F05 s5625 Oldfield Bank V241747 020805 Stage 4.doc Version 1.40 Page 26 - 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!