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Inspection on 24/05/05 for Orme House Residential Home

Also see our care home review for Orme House Residential Home for more information

This inspection was carried out on 24th May 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Positive feedback from residents and relatives included praise of the food on offer, those spoken to enjoyed the quality of meals on offer, residents felt well cared for by sufficient staff and both resident s and relatives felt the home was clean. All those asked were aware of what to if they were unhappy and had any concerns about the service. The new cook at the home knows the residents well and takes time to understand and provide for individuals preferences. The staff group are friendly to all who visited and were willing to discuss matters with the inspectors.

What has improved since the last inspection?

The environment at Orme House has steadily been improved. The first impression of a new hall and stairway carpet much improves the ambience of the home. New carpets and decoration of individual rooms has and continues to be ongoing. Staff recruitment files are now acceptable. Care staff have undertaken training in manual handling fire and first aid.

What the care home could do better:

Two specific area for development must be addressed in the coming months. Firstly care plans, there were three areas that need further work and more definition. In one care plan there was an infringement of rights. This issue must be agreed in a multidisciplinary setting and not decided upon by the home alone. In another care plan there need to be more detail in a manual handling assessment with details on pressure area relieve care. In the final care plan there needs to be a strategy for fall prevention and the inspector felt a referral to the falls prevention officer would support this. Secondly, the environment, this area has improved but attention must still be focused on outstanding matters. These include purchase of a laundry machine to adequately launder soiled linen, eliminate the odour of urine in three bedrooms and introduce paper towels in communal toilet areas. All these matters relate to infection control. Finally, repair the stair lift, attention to general repairs and privacy matters such as net curtains in bedrooms.

CARE HOMES FOR OLDER PEOPLE Orme House Residential Home 59 Kirkley Cliff Lowestoft Suffolk NR33 0DF Lead Inspector Claire Hutton Announced 24 May 2005 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. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Orme House Residential Home Address 59 Kirkley Cliff Lowestoft Suffolk NR33 0DF 01502 574068 01502 574068 None provided Anglia Care Homes Ltd 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) Mr Shriraj Sahadew Care Home 19 Category(ies) of OP, Older people (19) registration, with number of places Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 04/08/04 Brief Description of the Service: Orme House is registered as a care home providing personal care for 19 older people aged over 65 years. Care assistants staff Orme House on a 24-hour basis. One of the registered proprietors, Mr Sahdew is also the registered manager. The layout of the home is on 3 floors with level access provided in most areas by means of a shaft lift. Rooms 5, 6 and 11 are not accessible by the shaft lift. A stair lift can be used to access rooms 5 and 6, but to access room 11 the occupant needs to use stairs. Single bedrooms and shared accommodation are available. Communal space comprises of a large lounge and conservatory/dining room. Both areas have a television and music provided. There are bathing/shower facilities. A hoist was available for assisted bathing. The home looks out to Kirkley Cliff, a busy one-way thoroughfare. Kensington Gardens, with its many attractions and sea front, is just across the road from the home and easily accessible. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours on a mid week day in May. Jane Offord, a new inspector accompanied the lead inspector as part of her induction programme. Two working days before the inspection, the CSCI office received a complaint and therefore investigated the matters as part of this inspection. Two additional unannounced inspections, because of complaints, had been made since the last announced inspection. Letters and reports sent to the registered person following those visits can be obtained from the CSCI office on request. The owners have applied to have a condition on their registration to accommodate one individual resident at the home with dementia. The CSCI is processing this request. During the inspection 6 staff were spoken with, discussions were had with 3 visitors/relatives and 6 residents were spoken with, some in private. The manager facilitated the inspection and was available throughout the day. A tour of all the accommodation. Records inspected included all care records for three residents, recruitment records for three staff, the roters, the complaints records and evidence of staff training. What the service does well: What has improved since the last inspection? The environment at Orme House has steadily been improved. The first impression of a new hall and stairway carpet much improves the ambience of Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 6 the home. New carpets and decoration of individual rooms has and continues to be ongoing. Staff recruitment files are now acceptable. Care staff have undertaken training in manual handling fire and first aid. 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. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 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 Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 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, and 4. 6 does not apply People who use this service can expect to have an assessment before they move into the home and be able to visit before placement therefore, they can have an assurance that the home will meet their needs. EVIDENCE: Documentation for three current residents was examined. An assessment of care needs had been made for all three individuals before moving into the home. In two of these cases, introductory visits had been made and these were well documented as to how the new individual responded and care given. Relatives spoken with stated that a social worker had found the home for them and then they visited. The relatives spoken to felt the home did meet the needs of their relative. Three residents spoken with also felt their needs were met. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 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) 7,8,9,10 and 11 People who use this service can expect to have an individual plan of care in place, however the consistency of quality cannot be assured. Residents can expect to have their health and basic medication needs attended to, but cannot be certain every resident will have their rights promoted on all occasions. EVIDENCE: An individual plan of care was in place for three residents documents examined. These had evidence of regular review, along with evidence of assessment on dependency levels, falls assessment and pressure area assessment. From these assessments individual plans were developed. Some had good individual elements in place. That had clear instructions for staff on how to give individual care. Examples were stoma care. An assessment had been made, care staff trained by the continence promotion nurse, an individual plan for stoma care was in place and there was good recording of the care given along with review. Another good example of care planning was in the risk assessment developed by the manager on one individual ‘at risk of walking out of Orme House without notice’. This was in response to a recent incident. This level of detail was in place for several aspects of care plans but there were also some gaps where care plans had not been fully developed. Examples of Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 10 this included on person who had 23 falls recorded. The risk assessment in place stated they were at a high risk of falling and then there was no strategy in place to prevent falls. It was recommended that the local falls prevention officer be contacted for those assessed at high risk to help develop a prevention strategy of injury from falls if possible. In another plan, the aspect of manual handling care must be more detailed. It should state the name of hoist to be used, type of sling and in what position to use the sling. Exact detail of the assessed needs should be given in instruction to care staff for them to follow, to ensure continuity of care and safety. The same care plan also required clear instruction of pressure area prevention as the person was assessed as high risk. Finally, one other plan had good documentation overall and had good health support from three different disciplines within the health service. There was regular involvement of a community psychiatric nurse (CPN). However, the Care Plan Approach (CPA) used in mental health services was not fully integrated into the care plan at the home. There was evidence of the individual’s rights been infringed in terms of use of the telephone. This was not agreed in the CPA and therefore should not be imposed by the home unless agreement has been reached. There had been an incident where one resident felt one member of staff had treated them in a disrespectful way. The manager had investigated this and dealt with the matter. Two other residents spoken with felt they were treated with respect at all times by care staff and named some very caring staff that they especially liked. A district nurse arrived at 10am and attended to two people resident at the home. Residents were all said to be registered with a local GP and documentation of three files confirmed this. One relative was particularly pleased that the ‘deputy’ at the home had understood the importance of specialist blood tests their relative had to have and sorted it all out for them. This included transport to the hospital and communication of all aspects that reassured the family and the resident. Medication administration records were examined. These were well kept, but staff must be reminded to use the code at the bottom of the page. All staff who administer medication are trained, evidence was seen, except for one person who must be trained as soon as possible. The home have some medication that is administered as and when required (PRN). The instructions from the chemist and GP must be explicit for care staff to follow and not have any ambiguity, as was the case on more than one record. There was however explicit instruction on administration of one persons warfarin, which was good practice. Care plans examined all contained good documentation on final wishes and what the individual resident and their family wanted to happen at the time of a residents death. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 11 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, and 15 People who use this service can expect to receive an appealing balanced diet that they like and a degree of social activity on offer that they may or may not choose, therefore the home offer a lifestyle that can be determined by the resident. EVIDENCE: Each day one member of care staff was said to be allocated the task of social entertainment and would ensure an activity was on offer generally in an afternoon. The staff communication book confirmed this as each day all tasks were allotted to individual staff by the senior on duty. On the day of inspection a quiz was held in the lounge and all residents were invited to join in. Several people appeared to enjoy the quiz, including one inspector. One resident spoke to said that they had plenty of activities on offer and that they joined in most of them. Whereas one other resident felt it was all darts and bingo and they chose not to join in. The service users guide, available at the home, sets out arrangements for visiting as ‘no set visiting hours’, but to be mindful of the homes routine and wishes and privacy of the residents. On the day of inspection there were three sets of relatives/visitors at the home. Two sets spoken with said they were welcome anytime and that they were made to feel very welcome by staff. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 12 The menu on the day of inspection was sausage, egg and chips or fishcakes. And for dessert there were hot pears with cinnamon and custard. The cook was very responsive and spoke keenly about her role within the home. The cook knew the individual residents likes and dislikes and was able to cater for special diets such as diabetes (as detailed in care plans). On the wall was her basic food hygiene certificate. Yesterday the cook had prepared jam tarts and today scones. Each day a fresh cake was made for the residents. Residents and relatives spoken with all felt the food was of good quality and sufficient in choice and quantity. One resident said ‘they feed us alright, you get a good mix of food’ Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 13 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 People who use this service will find a owner/manager who does take complaints and protection of residents seriously and will resolve matters. EVIDENCE: The home have an appropriate complaints procedure in place and this can be found in both the service users guide and the statement of purpose. Previously this was displayed at the home on the wall, but on this occasion it was not noticed. The record of complaints was examined and was appropriate in terms of a log of every complaint and evidence that it had been investigated. Two sets of relatives and one resident spoken with all said that if they had any concerns they would speak to the person in charge. As mentioned in the summary the CSCI had received a complaint before they came on the day and this was duly investigated during this announced inspection. Some of the concerns were not proven, but elements around the environment were proven and these are listed in the report and the subsequent requirements. Previous complaints investigated that have elements of action required by the owner/manager have all been actioned. The home have a copy of the Protection Of Vulnerable Adults (POVA) policy (June 2004). Recently the manager had to make himself more aware of this document and the national POVA listing. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 14 The recruitment records of three staff at the home were examined. The care staff all had full Criminal Record Bureau (CRB) checks in place. However, one person employed in housekeeping did not. The manager was unsure if this needed to be full CRB, this was confirmed and the manager agreed to ensure this was done a soon as possible. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 15 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, 22, 23, 24 and 26 The residents who use this service can be assured that there is a programme of redecoration and improvement taking place, but some areas require improvement to offer a safe environment in which to live. EVIDENCE: Since the last inspection there have been considerable improvements in the décor of the home. All the residents’ bedrooms are attractively painted and there is new carpet in the communal areas of the home and the majority of the bedrooms. New, more appropriate furniture for older people had been purchased for the conservatory. The manager has a programme of refurbishment and said that new carpets in the remaining bedrooms are part of the plan. Two residents were spoken with in the privacy of their rooms and both were happy with their rooms and that they suited their needs. One resident confirmed they had chosen the colour for their room. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 16 There was an odour of urine in three bedrooms which needs to be addressed. The windows in room 3 need screening from the road outside to maintain the privacy of the resident. In the en-suite in room 13 the new décor needs to be completed to cover the gap above the mirror. The over door glass panel in room 6 is obscured, at the request of the resident, but only with some hardboard and tacks. Room 4 which is on the ground floor, does not have an entrance door wide enough to allow access to a standard wheelchair. Room 9, which is a double occupancy room only had one armchair and room 1, also double occupancy, had no armchairs. The bathrooms and toilets were all clean and uncluttered. The toilet on the ground floor had the leak repaired and the door now closes to ensure privacy. The downstairs bathroom had an assisted bath for use by residents who could not access a usual bath. In the downstairs bathroom there were communal toiletries on the bath shelf. There was no paper towel dispenser but a terry towel was on the rail. This can be a source of cross infection and must be removed. The silicone bath seal in the bathroom on the first floor needs replacing. The laundry area has equipment stored in it that restricts the space and could cause a hazard to the staff working there. The washing machine does not have a sluicing facility. Staff are sluicing soiled laundry in a butler sink that is the only facility for hand washing in the laundry. This can be a source of cross infection and must be resolved. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 17 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) 27,28 and 29 People who use this service can expect to find sufficient staff who are appropriately recruited and have base line training therefore they are in safe hands but staff could be further trained. EVIDENCE: The Manager of the home is Mr Sahdew, he is also one of the owners. He works at the home each day, Monday to Friday from 09.000 until 15.00. He is in addition to care staff. Each day there are two care staff on duty and one senior carer. The care staff are supported by a cook who works each day and two cleaning staff. One senior is always on call. The roters from the last two weeks, the current week and the coming week were examined and confirmed that staffing levels were maintained and planned appropriately. Currently there were no staff vacancies. All the residents and relatives spoken with felt there were sufficient staff on duty. Staff had recently received training in manual handling, first aid and fire prevention and certificates were seen. Currently the home has one member of staff with NVQ level 2 in care. Two other carer are currently on the course and two more staff are due to start in September 2005. Recruitments records for three staff were examined, these were much improved and all the required checks were in place to ensure the safety of residents except for one CRB on one member of staff in housekeeping. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 18 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, and 38 People who use this service can expect to find a competent approachable manager. However, currently not all aspects of health and safety are in place. EVIDENCE: The registered manager of the home is Mr Sahdew, he and his wife are joint owners and have another home in Essex. Mr Sahdew is a qualified nurse and he is currently undertaking the care management award NVQ 4. Both Mr and Mrs Sahdew have recently become trainers in first aid and manual handling. Staff spoken with, two residents and one relative all said that Mr Sahdew was approachable and that they were confident that he would resolve issues for them. Mr Sahdew was very helpful throughout the inspection process. The health and safety of staff and residents has been improved upon in terms of training offered to staff, equipment provided and assessments carried out, Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 19 but more must be done particularly in terms of fall prevention and risk of spread of infection. In the laundry the disused equipment is a potential hazard and should be removed, but more importantly the laundering of soiled linen must be safely managed. The records for the shaft lift and stair lift were examined and found up to date. One element of the complaint made was that they were stuck in the lift. This was unfortunate as it was due to overloading the lift. The manager agreed to post a notice stating the number of people the lift can carry. Maintenance records are up to date and there are clear instructions to staff on what to do in the event of the lift stopping. The home also has a 24 hour call out contract with a lift engineer. The stair lift was not working. This was said to be due to the carpet recently being laid and that it would be back in working order soon. An assessment of each resident who uses the stair lift must be made as to their need for individual assistance. The level of need or independence must go in their care plan. In addition operating instructions must be placed at either end of the stair lift. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 20 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 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 3 2 3 2 x 1 STAFFING Standard No Score 27 3 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x x 1 Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 21 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 7 Regulation 15(1) Requirement Timescale for action immedate 2. 9 3. 10 4. 19 Individual care planning approach must be further developed and give explict instruction for staff for: - Integrated care plan approach with CPN - Detailed manual handling assessments and pressure area care - Falls prevention statategy. 13(2) A protocol for individual as and when required (PRN) medication must be in each persons medication documentation. Staff must be reminded to use the code on drug sheets. The one untrained person must training. 12 (1)(3) All residents must have easy 16(2)(b) access to a telephone unless the infringement of rights is agreed and documented. All staff must be intructed to treat residents with respect at all times. 13 (3) 23 Residents must live in a safe and (2) (b) (d) well maintained environment therefore: - the paintwork around the mirror in room 13 ensuite must be made good. I54-I04 S49444 Orme V218149 050524 Stage 4.doc immediate immediate 01/09/05 Orme House Residential Home Version 1.30 Page 22 5. 22 23 (2) (a) (n) 6. 24 12 (4)(a) 16 (2)(c) 7. 26 13 (3) 23(2)( K) 8. 9. 10. 28 29 38 18(1)(a) 19 (4) 12(1)(a) - the door panel in room 6 must be fitted and made secure. - the silicone bath seal around the upstairs bath must be renewed. The environment must meet the needs of residents who live there therfore the door to room 4 must be made accessible to a wheel chair, this should be a 800mm clear openeing Residents bedrooms must be comforatble and private therfore: - a curtain must be must be placed at all windows in room 3. - There must be adequate seating in rooms 9 and 1. The home must be hygenic, free from odour and control the spread of infection therefore: - The odour of urine must be eliminated from rooms 10,15 and 7. - Paper towels and liquid soap must be provided in all communal toilets. - Use of communal toiletries must be stopped and residents own toiletries returned to their room after use. - A washing machine with a sluicing programme that meets discinfecting satndards must be provided. (This is a repeat requirement from 25/06/04) 50 of care staff must be trained to NVQ 2 in Care by 2005 All people who work at the home must have an enhanced CRB disclosure or POVA ist check. The health and safety of people in Orme House must be further protected the registered manager must ensure safe working practices around infection control and the stair lift. 01/09/05 immediate immediate immediate immediate 01/09/05 31/12/05 immediate immediate Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 23 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. Refer to Standard 7 38 Good Practice Recommendations The advice of the local falls prevention officer should be sought were residents are assessed as high risk. A notice should be posted in the lift as to the maximum number of people to be carried. Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection St Vincents House Cutler Street Ipswich IP1 1UQ 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 Orme House Residential Home I54-I04 S49444 Orme V218149 050524 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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