Inspection on 30/07/07 for Oldfield Bank

This inspection was carried out on 30th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Oldfield Bank 12/09/06

Oldfield Bank 21/12/05

Oldfield Bank 02/08/05

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 Kath Oldham Unannounced Inspection 30th July 2007 09:20 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Oldfield Bank DS0000005625.V338983.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. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oldfield Bank Address 5 Highgate Road Altrincham Cheshire WA14 4QZ 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) 0161 928 0658 0161 929 0734 oldfieldbankrch1@btconnect.com Mrs Anne Leavy Mr Lawrence Leavy Mrs Anne Leavy Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability over 65 years of age (0) of places Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users will fall within the category of old age and may additionally have a physical disability. 12th September 2006 Date of last inspection Brief Description of the Service: Oldfield Bank provides accommodation and personal care for up to twentyeight 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. At the time of this inspection it was reported that the home’s charges for care and accommodation ranged from £500 to £550 per week. The home has a service users guide and statement of purpose both of which are available to prospective service users upon request. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced, which means Oldfield Bank were not told we would be visiting, and took place on 30th July 2007 commencing at 9.20am. The inspection of Oldfield Bank included a look at all available information received by the Commission for Social Care Inspection (CSCI) about the service provided since the last inspection. This included the manager filling in a questionnaire about the home, which gave information about the residents, the staff and the building. Comment cards were sent to Oldfield Bank prior to the inspection for distribution to people living at Oldfield Bank, visitors and families, the views expressed in returned comment cards and those given directly to the inspector are included in this report. We got our information at the visit by observing care practices, talking with people staying at Oldfield Bank; talking with the deputy manager and staff. A tour of Oldfield Bank was also undertaken and a sample of care, employment and health and safety records seen. The main focus of the inspection was to understand how Oldfield Bank was meeting the needs of residents and how well the staff were themselves supported by the home to make sure that they had the skills, training and supervision needed to meet the needs of service users. The care service provided to three residents was looked at in detail to help form an opinion of the quality of the care provided. A brief explanation of the inspection process was provided to the deputy manager of Oldfield Bank at the beginning of the visit and time was spent at the end of the visit to provide verbal feedback. What the service does well: The home’s décor, furniture and the facilities are of a good standard. Each resident is registered with a local General Practitioner (GP) and where possible residents are able to retain their own GP. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 6 The home had a comfortable and homely atmosphere. The home carries out an assessment of need on all prospective residents before an offer of a place is confirmed. Residents are able to attend religious services either in the local community or a minister of their chosen faith can visit them in the home if preferred. Family and friends are encouraged to visit regularly. Where this is not possible staff at the home will assist residents to maintain contact via telephone or letter. The home has a complaint procedure and information about how to make a complaint is included in the home’s statement of purpose. Relatives and residents made positive comments about the care and support they or there cared for resident receives at Oldfield Bank. Comments included, “The staff are always busy and have to work very hard but they are always very kind and caring”. “All staff and carers are very kind and helpful, and queries are dealt with as soon as possible”. “Speaking as a relative, any member of staff are only too ready to listen to a resident if needed”. “Staff are always on hand to give help if required”. What has improved since the last inspection? The care plans have been changed since the last inspection this helps staff to have the details they need to provide care and support to residents. Risk assessments have been undertaken to identify whether there are any risks to residents and what action should be taken to reduce these risks whilst maintaining residents independence. The administration of medication has been improved with attention being taken to ensure staff sign when they give out medication and residents get what they are prescribed by their GP. The policy for medication has been updated to reflect practice and this has been sent to the Commission pharmacy inspector to check it out. The owner of the Oldfield Bank has taken on the role as the activities coordinator, which gives residents an opportunity to have some stimulation during the day. Entertainers are arranged periodically which some residents said they enjoyed. A manicurist comes to the home weekly and singing or a quiz is also arranged each week. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 7 A new infection control policy is in place and staff have read this policy and have changed their routines to minimise the risk of infection. There has been a change to the storage of records to ensure confidentiality of information. 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. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 8 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 Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive the information they require about the home and are able to visit before making any decisions to move in. They have their care needs assessed. EVIDENCE: The deputy manager would visit the person prior to admission to carry out a pre-admission assessment. This is to make sure that the home can meet the person’s needs. The home has started to use a new pre-admission assessment form. This is then used to develop a care plan. One service user said, “Karen invited me to visit and have lunch so I knew some faces before I moved in”. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 10 A sample of care files was examined. The pre-admission assessment form was in place on all files looked at. These assessments contain information relating to residents physical and mental health, personal care and social needs. This home does not provide intermediate care. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Personal support is offered in such a way as to promote and protect people’s privacy and dignity. Medication practice needs developing further. EVIDENCE: A care plan was available for each person accommodated. Each care plan seen included personal details, personal assessment, past history, mobility, personal care, dressing/undressing, eating and drinking, living, working and recreation, communication, resting and sleeping and worshipping. A daily record of the person’s progress was also in place. The detail written in the daily reports was on occasions staffs perception of how a resident was feeling. Staff need to receive direction and supervision in what should be written in these records. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 12 There was evidence that care plans were under review and that information was being updated to ensure information was current and relevant. There was clear evidence in residents care files of the involvement of a range of healthcare professionals to meet needs. This included a referral to an occupational therapist for a resident whose mobility had been affected following a stroke, as well as support to meet residents’ mental health needs. A resident said, “There is a good link between the care home and my GP. There are regular visits by district nurses”. A relative said, “The staff and management are very caring people and I am happy that my cared for relative is in their care”. Another relative said, “We have been very happy with the care our cared for relative has received”. “The staff always treat the residents with dignity, are kind and helpful”. The deputy manager weighs residents monthly and this is recorded. The deputy said she prefers to do this herself so if there are any changes in weight they can be addressed. Risk assessments concerning all aspects of risk to each individual, including the risk of falls had been completed. A health professional stated, “Very caring and always appear to ensure best outcome for residents”. Examination of a sample of residents medication records identified that they had been completed properly and residents were recorded to have received their medication as prescribed by their GP. A health professional said, “All medications are in dossette boxes to ensure accuracy when given to residents”. Best practice indicates that the administration of certain medications are double signed in the medication records this safeguards the home and also is a double check that the correct medication has been administered. The doctor prescribes some residents creams. To ensure these are administered, as often as they should be a record should be made of when they are applied. This gives the home the opportunity to check if the cream is working and refer back if it is not with detail on how many times it has been applied. Some residents are prescribed a varying dosage of medication, for example one or two tablets. To ensure a clear record is available of all medication administered the actual amount should be indicated on the medication records. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 13 Some medication has limited shelf life and the date when it is opened needs to be detailed on the medication to ensure it is disposed of on the expiry date. This detail was included on the medication records but needs to be on the actual medication. This ensures that it is clear when medication should be disposed of. A resident said, “I always receive antibiotics if I need them straight away”. One medication prescribed appeared not to have been given to a resident. The deputy manager said that this was because it was only needed now and again by the resident. The prescription did not indicate this. An up to date list of staff who have been trained and who are competent to give out medication needs to be kept with the medication records, this record should include the signature and initials of staff. A refrigerator was provided for the storage of those prescribed medicines requiring cold storage. The refrigerator didn’t have a lock fitted, which needs to be addressed. Records of medicines received at the home and returns to the pharmacist for destruction were kept. In response to the question do you receive the medical support you need a relative/friend responded, “Impossible to answer always because we are not always there and my cared for relative health is variable; equally, within the general scheme of things it is deteriating. However, the management has strong links with the local doctor who is always on hand, and my cared for relative is regularly taken to a range of hospital visits and therefore given very good support particularly by the deputy manager”. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People living at the home have a flexible lifestyle and receive an appropriate diet. EVIDENCE: The home has an open visiting policy and relatives and friends of residents are able to visit at any time during the day. The residents are able to receive visitors in the privacy of their own rooms or in one of the communal lounges. There are no restrictions on visiting unless the resident has agreed this. Visitors were seen to come and go at Oldfield Bank and they confirmed that they were always made welcome by staff. The owner is now the activities coordinator and provides activities on three days each week. A manicurist comes to the home weekly and an entertainer comes in and does sing-a-longs or quizzes. Trips out are also now arranged. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 15 One resident said “we have activities displayed on the board every week and have recently been on a day trip to Knowsley Safari Park”. A relative said, “There has been a new initiative on activities and visits. On Saturdays residents and carers are going on a coach trip to Knowsley Safari Park”. A further relative said, “Staff try to do things with the residents to stimulate them”. A resident commented, “There are regular activities which I enjoy and take part in as far as I am able”. An activities boiard is displayed in the hall and details the planned activities. There is not a record kept of the activities or who has taken part so it is not clear how many people take part. The meal of the day is detailed on a board in the dining room. We were told that residents have a choice of meal. The record kept of the meal in a ‘diary’ did not detail any variations to the main meal. Oldfield Bank doesn’t have, for example a written four week menu which is followed. The meals are varied over the weeks. The diary indicated that residents were provided with soup and main meal and sweet at lunchtime and a lighter meal in the evening. There were no records of what residents had for supper. A relative said, “My cared for resident liking of the meals varies because of her age, illnesses and moods. In my view they are usually well prepared, nutritional and adequate.” Another relative indicated, “My cared for relative seems to enjoy all her meals as the staff say she has a good appetite. Unfortunately her memory eludes her shortly afterwards by forgetting what she has had”. A resident said, “There is a good variety of food which I always enjoy”. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents appear satisfied with the service provided and feel safe. EVIDENCE: There was a complaint book in place that detailed complaints received by Oldfield Bank. Complaints were dealt with appropriately. Oldfield Bank could further demonstrate their commitment to dealing with comments received by further developing the recording within the complaints book. The Commission for Social Care Inspection has not received any complaints or comcerns regarding this home since the last inspection. One comment card stated that they were aware of the complaints procedure and that if they had a complaint they felt it would be responded to appropriately. A resident said, “There is always someone to speak to if I am not happy and my relatives are regular visitors and they always talk to staff to check on my situation”. Policies and procedures were in place to help staff protect the residents from harm or abuse. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 17 Safeguarding of vulnerable adults training has not been received by all staff at Oldfield Bank, which means that all staff may not be able to recognise abusive situations or know how to respond to these. The deputy said they were waiting for places to be allocated to them for this training from the Local Authority. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The home provides a comfortable environment for residents with specialist equipment available as required by individual residents. The standard of decoration was generally well maintained. Some maintenance jobs need to be addressed. EVIDENCE: The home provides people with a clean, tidy and homely environment with no offensive odours. The decoration, both externally and internally, was of a good standard and the furniture was what you would expect to see in someone’s own home. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 19 Residents were seen sitting in various lounges listening to music or reading and there was a good staff presence. Staff in one lounge were observed in discussions with residents. Bedrooms were personalised with items brought from resident’s homes. Some had a television and chose to spend time in the privacy of their rooms when they wished. Resident’s bedrooms had been fitted with a privacy lock suited to their capabilities and accessible to staff in emergencies. One of the locks was missing and needed replacement. The number of the bedroom and the name of the resident were on the door, which helps residents to find their rooms. On the tour of the building it was observed that a number of the sinks within bathrooms or toilets didn’t have a plug, so residents wouldn’t have been able to wash in the sink. This needs to be remedied. One of the bathrooms contained dressings and equipment used by visiting nurses and a sharps bin for the disposal of needles, which should be placed elsewhere so as to minimise the risk of injury to residents. Residents have over bed tables in their rooms these are used for meals on occasions. A couple of these tables were worn and needed replacement. Some of the bathrooms and toilets do not have a call bell in place. This has been the case since registration. The deputy manager said for one of the bathrooms that residents did not use it alone. This bathroom door only closed with difficulty and needed some attention. Two of the bathrooms contained prescribed creams. These creams should be in a locked cupboard as they are prescribed medication. The storage of these within bathrooms could mean that staff use for other people, which could result in cross infection. Grab rails and other aids were provided in the bathroom and some of the communal areas to support residents’ mobility. Two of the bedroom carpets needed replacement as they were showing signs of wear and tear. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The numbers and skill mix of staff appeared sufficient to meet the needs of the residents accommodated. Shortfalls in undertaking the required preemployment checks potentially place the welfare and safety of residents at risk. EVIDENCE: Staff files examined indicated that the staff received supervision to allow them to support the residents appropriately. This was confirmed in discussion with staff one said “I have supervision with the deputy manager, we discuss the residents and any training”. Another said “yes we get supervision about every 8-weeks we talk about the residents needs and any problems”. In response to the question, Do the care staff have the right skills and experience to support individuals social and health care needs”, a health professional said, “Most of the staff have been there for several years which I feel indicates that this is a good care home. A GP responded, in their experience of visiting the home to one service user said, “Unaware of staff training/experience, but never been given reason to question this, staff have always acted in professional manner”. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 21 The rota needs some amendments to ensure that the full name of staff are indicated. Staff are provided with the organisations code of conduct and arrangements were in place to ensure all staff had received the General Social Care Councils Code of Conduct (GSCC). A relative/visitor commented, “The staff are friendly, sympathetic and responsive. They work very hard. Just occasionally, use of English as a second language means that there may be loss of nuance from the residents perspective-though there is no lack of kindness and good intention”. Three staff files were looked at,all were appointed since the last inspection. On the last inspection it was identified that the recruitment and selection procedure did not safeguard residents in that criminal record disclosures had not been received before staff commenced employment. This practice has not changed. One new staff member had commenced employment before the check had been requested. A second had brought a criminal record bureau disclosure from there previous employment. This is not acceptable. The requirement to undertake this is repeated. A company is used by Oldfield Bank to undertake training in moving and handling, food hygiene, drug awareness and demetia care. Five staff have recently attended induction training to commence NVQ 2. Some staff have not yet received moving and handling training. The deputy manager said that these staff do not undertake any moving and handling procedures until this training is completed. A relative said, “I have no adverse comments to make about Oldfield Bank management or staff as I am satisfied that they provide a caring and loving home for my cared for relative who is totally dependent on them for there wellbeing. Residents comments regarding staff included, “There are always staff in the lounge area- no one is ever left alone”. “Always attentive. Friendly caring staff”. “Staff are usually available when you need them” and added, “and if they are busy they explain and don’t forget about me”. Staff were reported to have attended induction and foundation training to Skills for care specification. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Oldfield Bank has demonstrated that it takes the views of residents and their representatives seriously and uses feedback to make ongoing improvements to the care that residents receive. EVIDENCE: The deputy manager was fully aware of her responsibilities and was seen to be sensitive, caring and professional towards the people living at Oldfield Bank and towards the staff. The home’s certificate of registration was displayed in the entrance hall. This was accurate and up to date. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 23 It was reported that the home does not manage the financial affairs of residents at Oldfield Bank. Families assist residents who are unable to manage their own finances. Relevant certificates were on file to show that appropriate servicing of equipment used by residents in the home had been carried out. Fixed gas and electricity appliances had been regularly maintained and a periodic test of portable appliances and lifting equipment had been carried out. Checks to the fire safety equipment were up to date. Fire equipment had been regularly maintained. When undertaking fire drills and practices best practice is that staff sign next to their printed name to confirm their attendance to the drill or practice and confirm they know what to do in an emergency situation. This development would support Oldfield Bank in showing that all staff have received these drills and practice. The questionnaire completed by Oldfield Bank and sent to the Commission showed that health and safety checks were being carried out. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 24 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 (1) Requirement Criminal Record Bureau checks and two written references must be obtained prior to confirming staff in post. (Previous timescale of 12/10/06 not met). Timescale for action 30/07/07 Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 26 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 OP7 Good Practice Recommendations Provide staff with supervision and direction in what should be written within the daily reports ensuring the record is not recording staffs judgements about how a resident is feeling. And the record details the care and support residents receive. To safeguard the home and to ensure service users receive controlled drugs as prescribed arrange for a second staff member also to sign the medication administration records. All prescribed medicine including creams should be recorded when administered and that where not required details are recorded. An up to date list of signatures of trained staff that have responsibility and are competent to administer medicines should be maintained. Make sure that all medication prescribed to residents clearly states if it is to be administered now and again (PRN) as opposed to every day. The refrigerator, which stores medication, should have a lock fitted to ensure that the medication is kept securely. To ensure medication that has limited shelf life is disposed of at the correct time, the date of opening this kind of medication needs to be indicated on the actual medication. To demonstrate the organised activities and to record who has taken part; make a record of the activities organised inside and out of the home and the name of the resident attending the activity. Maintain a record of food served to residents so anyone looking at the record can make a judgement that the diet is sufficient in terms of nutrition and would evidence that residents do have a choice of meals. Provide safeguarding adults training to all staff to ensure that all staff are able to recognise abusive situations or know how to respond to these. To promote residents privacy and dignity an audit of maintenance work needs to be undertaken within the DS0000005625.V338983.R01.S.doc Version 5.2 Page 27 2 OP9 3 4 5 6 7 8 OP9 OP9 OP9 OP9 OP9 OP12 9 OP15 10 11 OP18 OP19 Oldfield Bank 12 OP38 home, removing creams from bathrooms, repairing or replacing specific items within bedrooms, supplying plugs to all sinks, and storing dressings and nursing equipment within a safe environment. To show that staff have received fire drills and practice and they know what to do in an emergency situation a record should be kept with staff signing next to their printed name when they have taken part in fire drill training and practice. Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection 11th Floor West Point 501 Chester Road Old Trafford Manchester M16 9HU 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 Oldfield Bank DS0000005625.V338983.R01.S.doc Version 5.2 Page 29 - 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!