CARE HOMES FOR OLDER PEOPLE
Oldfield Manor Oldfield Manor 14 Hawkshaw Avenue Darwen Lancs BB3 1QZ Lead Inspector
Mrs Jane Craig Key Unannounced Inspection 31 August 2006 09:30 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 Manor DS0000005832.V293182.R01.S.doc Version 5.1 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 Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Oldfield Manor Address Oldfield Manor 14 Hawkshaw Avenue Darwen Lancs BB3 1QZ 01254 705650 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) Oldfield Manor Limited Mrs Carol Ann Waddicor Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 5th January 2006 Date of last inspection Brief Description of the Service: Oldfield Manor is a converted two storey building set in its own grounds. There is car parking space at the front of the building. It is situated about 200 yards from the main Blackburn to Darwen main road, where there are a variety of shops and retail premises. This road is a bus route. The home is approximately one mile from Darwen town centre. Oldfield Manor is owned privately and is part of a small local group of three homes. Accommodation is provided on two floors. There are 15 single rooms and 1 double room. Some rooms have an ensuite facility (W.C. and wash hand basin). There is one lounge with a conservatory extension and a separate dining room. There are bathing and W.C. facilities on both floors of the home. A passenger lift connects the two floors. There is a sunken lawned garden at the front of the home which is accessed by steps. Access into the grounds from the home is via a ramp. A brochure about the home is sent to prospective service users whenever they make enquiries. Other information, including the latest CSCI inspection report is available to read during an initial visit to the home. The fees at 31st August 2006 were £354.00 per week. There were additional charges for newspapers, toiletries and hairdressing. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced key inspection took place over 10 hours. At the time of the visit there were 14 residents accommodated. The inspector met with a number of residents and spent time observing interactions between staff and residents. Wherever possible residents were asked about their views and experiences of living in the home and some of their comments are quoted in this report. Seven residents had completed comment cards before the inspection. Their views were mainly positive. During the inspection visit discussions were held with the registered manager, two members of staff and a visiting professional. The inspector made a tour of the premises and looked at a number of bedrooms. Records and documents were viewed. This report also includes information submitted by the registered manager prior to the inspection visit. What the service does well:
All the residents spoken with said the home was good. One resident said that at first they weren’t keen on the idea of going into a home but now they had “no regrets.” A number of residents expressed their satisfaction with the staff. One said, “the staff have been wonderful, I couldn’t say otherwise.” Another said, “the girls are so friendly and talk to you really nicely.” Residents said that staff looked after their health. One said, “I am very well looked after, the girls are very helpful.” They were generally satisfied with daily routines. One resident said, “everyone who comes into a home feels they lose a bit of control but we still have choices.” Others talked about there being no rules about when to get up or go to bed and said they were able to spend time in their rooms if they wanted to. Residents said the staff respected their privacy and always knocked on bedroom doors before going in. Most residents were very complimentary about the meals. Their comments included, “the meals suit me,” “they know what I don’t like so they don’t give it to me,” and “the cook is very good, we get a variety.” There were bowls of fresh fruit, sweets and a choice of cold drinks available in the lounge for residents to help themselves. Residents said they knew how to make a complaint and who to approach if they were not happy with something about the home. One resident said they had made several little complaints and they had been “soon dealt with.” New staff received training as soon as they started working with residents. This meant that they had a good understanding of the needs of the resident group and how to provide the right care. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 6 The manager was very committed to the residents and staff. She had the relevant experience and qualifications for the job. Because of staff shortages she had to work hands on to make up the numbers and had to work in her own time to keep management tasks up to date. What has improved since the last inspection? What they could do better:
Senior staff from Oldfield Manor did not complete assessments for prospective residents before they offered them a place at the home. This meant that staff did not have a clear picture of the resident’s needs and whether the environment and the staff team at Oldfield Manor could meet them. Care plans did not always tell staff enough about residents’ needs and what type and amount of care they should be receiving. Plans were not always kept up to date. This meant that staff did not always have the right directions and may result in residents’ needs not being met. There were no assessments or plans to show how risks to residents’ health, for example from falls, could be minimised. There were very few social or recreational activities for residents who were not able to occupy themselves. Several residents commented that there was not enough to do. For example one said, “it is a very boring life watching everyone fall asleep,” and another said, “not everyone wants to listen to childrens’ programmes for two hours.” There were few opportunities for residents to go out unless with their families. Many areas of the home were due for re-decoration and refurbishment. The fact that residents had shabby and mismatched furniture in their bedrooms showed a lack of respect. Residents must be able to live in a pleasant environment and be able to enjoy their personal living space. The manager had difficulties recruiting staff and there were not always enough staff on duty at the home. Residents said that the staff were very busy. One said that staff had too much to do which meant residents sometimes had to wait. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 7 Opportunities for staff training were not very good and essential health and safety training had not been carried out. Staff must also receive training in the protection of vulnerable adults to ensure that they would be able to recognise any abusive behaviour and know how and where to report it. Only 18 of care staff had a nationally recognised qualification instead of the recommended 50 . Residents did not have opportunities to air their views of the service or to make suggestions for change. This meant that changes in the home were made without the residents’ involvement. 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 Manor DS0000005832.V293182.R01.S.doc Version 5.1 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 Manor DS0000005832.V293182.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of preadmission assessment by staff from the home could result in inappropriate placements. EVIDENCE: Residents had access to information about the home. The statement of purpose and service user’s guide were due to be updated. All residents were given a contract and a copy of the terms and conditions of residency. The manager said that senior staff usually assessed prospective residents before they were offered a place at the home. However, there was no record of the assessments on three files seen. Staff said that the manager discussed the resident’s needs when they came in but the lack of written assessment meant that they did not have a baseline of written information to refer back to. The lack of assessments may also result in residents being admitted inappropriately. For example, one resident, with a history of mental health needs, had not been assessed to ensure that the staff group had the skills to
Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 10 meet their needs and that the new resident would fit in with the existing resident group. Oldfield Manor does not provide intermediate care. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. Shortfalls in assessment and care planning may result in ineffective and inconsistent care. There were some aspects of medicines management that may place residents at risk. EVIDENCE: The care records for three residents were inspected and others were viewed in less detail. The quality of the care plans varied. Plans to direct staff on how to provide personal care were generally quite detailed and explicit. Others such as mental health care plans and continence plans did not give staff adequate instructions. There was no evidence on two of the plans that residents, or their relatives, were involved in drawing them up. One resident said that they discussed their plan with the manager every so often but couldn’t remember signing it. Plans were reviewed but not always updated to reflect changes in the needs of the resident that were apparent from their daily notes. Residents’ health care needs were not always assessed. All three of the residents who were case tracked had a history of falls but there were no specific risk assessments in respect of falls. The daily notes for one resident
Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 12 indicated that he may be at risk of developing pressure sores but this was not assessed. One resident had high-risk moving and handling needs and was at high risk of developing pressure sores but there were no plans to help to minimise the risk. There were letters and records in residents’ files to indicate that they were referred to outside agencies when necessary. A visiting physiotherapist said that staff always made sure any instructions were always carried out. She also said that they communicated very well about the resident’s progress. Residents said their health care needs were met. One said, “you get looked after if you’re not so good so you have no worries.” Another resident talked about how staff helped him take care of his diabetes and said, “there’s always someone keeps an eye on me, they’re marvellous.” Although none of the care plans made specific mention of how the resident’s privacy and dignity would be maintained, staff directions helped residents to maintain their independence. New staff received training about care values and two talked about how they preserved residents’ privacy and dignity. Residents said that staff did not enter their rooms without knocking and throughout the inspection staff were seen to show respect when talking to residents. One resident said staff were very thoughtful for putting her preferred name on her care plan. There were improvements in the management of medicines. The medication policy had been reviewed to include procedures for disposal of medicines. There were clear records of medicines entering and leaving the home. One resident who was disabled was being supported to administer some of their own medication but there was no assessment to support this. Medication Administration Record (MAR) charts were complete except for a record of creams administered to residents. Handwritten entries were signed and witnessed. Staff had clear directions to follow when residents were prescribed “when required” medicines. Cream belonging to one resident was found in the bedroom of another, indicating that some medicines were being shared. Storage was safe and there was restricted access to keys. There was no excess stocks. Controlled drugs were stored, administered and recorded appropriately. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents had some choice and control over their daily lives. Routines, and meals suited residents but most residents’ social and recreational needs were not met. EVIDENCE: There was some information recorded on plans about residents’ likes and preferences but staff said all the current residents were able to make their own choices about daily routines. Several residents said there were no rules for going to bed or getting up. Residents were able to spend time in their rooms if they wish. One resident said, “everyone who comes into a care home feels they lose a bit of control but we still have choices.” There were set days for bathing but staff said there was some flexibility. Residents were happy with the arrangement. There had been no programme of social and recreational activities for the past few months. Staff said there was not enough time. Several residents, including those completing surveys made comments. One said, “it is a very boring life watching everyone fall asleep,” and another said “not everyone wants to listen to childrens’ programmes for two hours.” For residents who were able to entertain themselves, there were lots of books and magazines and some games in the lounge. There were not enough staff to escort residents outside the home.
Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 14 There was an open visiting policy. Some plans included information about relatives’ usual visiting patterns and any participation in care. One resident said her son was able to come when it was convenient for him and his work. Residents said they were able to see visitors in private. Residents did not have involvement in menu planning. There were no choices unless the resident did not like what was on the menu. Records of meals showed some repetition especially at tea-time. Despite this residents said they were happy with the meals. They said there was a variety. Other comments included, “good cook,” “foods been excellent as far as I’m concerned,” “nice meals.” There were bowls of fresh fruit, sweets and a choice of cold drinks available in the lounge for residents to help themselves. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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 were confident that complaints would be dealt with appropriately but the lack of training in adult protection issues may result in inappropriate responses to allegations. EVIDENCE: As recommended following the last inspection a revised, resident friendly complaints procedure was on display. Records showed that complaints, even minor issues, were investigated and acted upon. All the residents who completed surveys or were spoken with during the inspection said they knew who to speak to if they were not happy. One resident said, “people listen to what you have to say, it’s great,” another said that they had made several little complaints and they had been dealt with. There had been four minor complaints to the home since the last inspection; all had been dealt with appropriately. New staff covered adult protection issues during their induction but not all other staff were up to date with training in the protection of vulnerable adults. There was written guidance available in the home, including reporting procedures. However, not all the staff spoken with were completely clear on their role in responding to an allegation. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home was not in a good state of repair and did not provide a safe, comfortable and homely environment. There were some practices that may increase the spread of infection and create risks for residents. EVIDENCE: There was a plan for maintenance/development but this was not running to timescales. Repairs were reported but not carried out quickly and the home did not look well maintained. The lounge and conservatory areas were furnished in a homely way. Residents had photos and other personal possessions on their side tables. Most other areas of the home needed attention. The dining room floor needed a deep clean to ensure the crevices in the floor covering were clean. One of the residents’ toilets was being used as a storeroom. The shower room had cleaning items stored in it and staff stored their coats in the residents’ downstairs bathroom. All but one of the bedrooms had mismatched, and in most cases, shabby furniture, with handles missing from drawers.
Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 17 Several rooms needed re-decorating. There were no light shades in two rooms and one had a carpet that presented a trip hazard. There was a separate laundry area in the basement. It was adequately equipped for the size of the care home. The home was clean and fresh smelling. Residents who completed written surveys indicated that it was always like that. Some practices in the home may increase the risk of the spread of infection. For example, non-disposable washcloths and sponges were used to assist with the personal hygiene of residents with continence needs. There were no facilities for washing commode pans and this was done in one of the baths. There was no liquid soap in any of the bathrooms and toilets. Most staff were undertaking an infection control course at the time of the inspection. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is not always staffed to meet the needs and dependencies of the residents. There was a good standard of induction training but the lack of further training may result in residents’ needs not being understood and met. EVIDENCE: The manager and staff said that staffing levels had been lower than usual for a few months. This was due to difficulties in recruiting. Staff talked about how the shortages affected resident care, for example, activities or just sitting and talking to residents. They said that sometimes residents missed out on having a bath as often as they should because there were not enough staff. Residents agreed that there were staff shortages. One said, “they have too much to do and there are times you have to wait a bit,” another said that they did not miss out on anything because they were able to help themselves but that was not the case for everyone. Residents said that staff were very kind and caring. One said, “the girls are so friendly and they talk to you really nicely.” Others said, “the staff are wonderful,” and “you can have a laugh and joke with them.” There were improvements in the way new staff were recruited but not all the required documents and information were present on staff files. The application form was very basic and did not support the collection of information.
Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 19 Records showed that new staff had a first day induction, which included orientation to the home, policies and emergency procedures. They went on to complete the 12 week common induction standards and staff files included a certificate of competence. There was a lack of training opportunities for existing staff. Training in health and safety topics was not up to date. Only 3 staff were qualified in first aid and moving and handling training was out of date. Despite a number of residents having memory loss and confusion, only the manager had attended a course on dementia awareness. Only 18 of care staff had attained an NVQ. Six others were taking the course at the time of the inspection. A resident talked about how a number of staff had attended a course on diabetes, which he thought was very good and helped his confidence. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A qualified and experienced manager ran the home. Residents did not have sufficient opportunities to make their views known and influence change. Shortfalls in fire safety measures place residents and staff at risk. EVIDENCE: The manager held the NVQ 4 in care and had recently completed the Registered Managers Award. She had attended several short courses in order to improve her clinical and management skills. The manager was very committed to the job. She did not have any supernumerary hours and had kept many of the management tasks up to date by working in her own time. Staff and residents said she ran the home well and she was described as kind, supportive and fair. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 21 The Blackburn with Darwen quality assurance award had been withdrawn because of shortfalls in the service. There was a lack of consultation with residents to find out their views of the service and any suggestions for improvement. They had been invited to complete satisfaction surveys last year but the information had not been used to develop the service. Resident and staff meetings had ceased because of shortages of staff. Following a requirement at the last inspection the registered provider carried out, or had nominated a senior person to carry out, unannounced visits to the home. The visits included consultations with residents and staff and a check of the premises but there was no action plan to address any issues identified during the visits. Families generally handled the residents’ financial affairs. One resident managed their own. A small amount of money was held on behalf of three residents. Although there were records of all transactions, the calculations were not always correct. Because deposits and withdrawals were not witnessed and there were no audits, the inaccuracies had not been identified. Certificates were available to evidence maintenance of installations and equipment in the home. However, servicing of the fire alarm system was out of date. Staff had not received updated fire safety training and there had been no fire drills this year. Not all staff were completely clear of the fire procedure and their role in the event of fire. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 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 X X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 1 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 2 X X 2 Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 23 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 15(1) Requirement Care plans must adequately address all residents’ personal, health and social care needs. Timescale for action 30/11/06 2. OP7 15(1) Residents or their relatives must 30/11/06 have opportunities to be involved in drawing up and reviewing care plans. Care plans must be updated as and when changes occur. 30/11/06 30/11/06 3. 4. OP7 OP8 15 13(4)(b-c) Care plans must include risk assessments and plans, with particular attention to falls, moving and handling and pressure sore risk. Strategies must be drawn up to minimise risk. 13 (2) Medicines must only be administered to the resident for whom they were prescribed. There must be no sharing of creams or other preparations. (Timescale of 31/01/06 not met) Risk assessments must be in place for all residents who
DS0000005832.V293182.R01.S.doc 5. OP9 01/09/06 6. OP9 13(2) 01/09/06 Oldfield Manor Version 5.1 Page 24 administer their own medication. 7. OP9 13(2) Staff must sign MAR charts when any medicines (including creams) are administered. 01/09/06 8. OP12 16(2) (m-n) Following consultation with 30/11/06 residents a programme of activities must be devised. There must be sufficient appropriate activities to meet the social and recreational needs of the residents. All staff must receive update training in the protection of vulnerable adults. The registered person must conduct an audit of every bedroom and draw up an action plan for redecoration and refurbishment. The plan must include timescales for action. The carpet identified during the inspection as a trip hazard must be re-laid or replaced. The registered person must review infection control procedures and practices to minimise the risk of the spread of infection in the home. The registered person must ensure that there are sufficient staff on duty at all times to meet the needs and dependencies of the residents. The registered person must ensure that all staff files contain all of the information as required in Schedule 2. (Timescale of 31/03/06 not met) 31/12/06 9. OP18 13(6) 10. OP19 23(2) 31/10/06 11. OP19 13(4) 30/09/06 12. OP26 13(3) 30/11/06 13. OP27 18(1)(a) 01/09/06 14. OP29 19 (4)(b) Schedule 2 31/10/06 Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 25 15. OP30 18(1) Staff must receive training appropriate to the work they are to perform. This would include: Training in safe working practice topics Dementia care training The registered person must develop a system for monitoring and improving the quality of the service. 31/12/06 16. OP33 24 31/01/07 17. OP35 Schedule 4 (9) Records must be kept of financial 30/09/06 transactions made on behalf of residents. The records should be witnessed and regularly audited to ensure they are correct. The registered person must improve fire safety measures in the home. This includes: • Fire safety training • Fire practice drills • Servicing of the fire alarm system • A clear procedure understood by all staff 31/12/06 18. OP38 23(4) 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 OP3 OP7 OP28 Good Practice Recommendations Staff should assess prospective residents before they are offered a place at the home. Care plans should be signed and dated. 50 of care staff should be trained to NVQ level 2 or above. Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 26 Oldfield Manor DS0000005832.V293182.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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