Inspection on 22/02/06 for Oxfield Court Nursing Home

This inspection was carried out on 22nd February 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 18 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Oxfield Court Nursing Home 16/04/08

Oxfield Court Nursing Home 31/10/07

Oxfield Court Nursing Home 22/03/07

Oxfield Court Nursing Home 30/06/06

Oxfield Court Nursing Home 11/11/05

Oxfield Court Nursing Home 01/03/05

Oxfield Court Nursing Home 14/07/04

Oxfield Court Nursing Home 13/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 Oxfield Court Nursing Home Oxfield Court Albany Road Dalton Huddersfield West Yorkshire HD5 9UZ Lead Inspector Alison McCabe and Helen Battle Unannounced Inspection 22nd February 2006 10:15 Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 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 Oxfield Court Nursing Home DS0000001124.V271224.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 Adults 18-65. 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. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Oxfield Court Nursing Home Address 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) Oxfield Court Albany Road Dalton Huddersfield West Yorkshire HD5 9UZ 01484 424232 01484 428967 St Anne`s Community Services Mrs Judith Bermingham Care Home 28 Category(ies) of Learning disability (28) registration, with number of places Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th November 2005 Brief Description of the Service: Oxfield Court is operated by St Anne’s Community Services and it is registered to provide nursing care and accommodation for up to twenty-eight adults with a learning disability. Oxfield Court is a complex of five purpose-built brick bungalows situated in a quiet cul-de-sac. All the local amenities are within a couple of minutes walk. Service users have access to the garden areas and there is ample parking. A day centre is also situated on the same site. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.15am and 3.00pm and was conducted by two inspectors. As part of this inspection, a tour of the houses was conducted where communal areas and a sample of service user bedrooms were seen. Discussion with staff and some service users took place and records relating to service users, staff and the maintenance of the home were examined. Feedback received from staff was mixed. Some staff reported enjoying their work and feeling motivated, while it was reported in some houses that staff morale was low and staff were feeling under pressure due to not having enough time to complete tasks. A service user who showed an inspector around her home reported being happy and liking living at Oxfield Court. A number of requirements and recommendations made at the previous inspection have not been addressed and are therefore repeated. What the service does well: Service users’ needs are assessed appropriately prior to them being offered a place at Oxfield Court. Clear and detailed individual care plans and risks assessments are in place for some service users that give good guidance to staff about how to meet individuals’ needs. Service users’ healthcare needs are generally met. Some service users have enjoyed short breaks away from the home with support from staff. Service users live in a clean, comfortable home. Most service users’ bedrooms are furnished to a high standard. A good range of equipment and adaptations are provided to help service users to be as independent as possible and protect staff when they are supporting service users in mobilising. Most records are well maintained. Service users benefit from living in a home that is managed by a qualified, experienced manager. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Prospective service users’ needs are assessed as required. EVIDENCE: Evidence was seen in records that service users’ needs are assessed prior to being admitted to the home. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,9 Individual care plans for some service users are clear, detailed and current. However, this needs to be standardised across the service. Risk management is generally good although some risk assessments require further detail and updating. Where physical intervention may be required, clear strategies need to be identified. EVIDENCE: Once again, it was found that there were wide variations between the individual care plans seen in the bungalows. Some care plans provided good, clear detail about how service users’ needs should be met, with clear objectives. There was evidence that some service users had been involved in person centred planning meetings. It was noted that some identified areas of need detailed in assessments had not been transferred to the care plan. For example, it was identified that a service user required specific support with bathing, however this was not mentioned in the care plan. The format of some service user plans made it difficult to find current information. There was evidence in some plans that identified goals are Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 10 monitored on a weekly or monthly basis to check if the goals/objectives are being met, and this is positive. It is concerning that a number of service users’ goals had not been achieved. In one service user’s records, it was seen that five objectives had been set in December 2004. Only one of these had been achieved. The reasons recorded for these objectives not being met were staff shortages, inconsistency of staff and behaviour of service user. The inspector was concerned that a modest objective to go swimming three times in a year had not been achieved, and improving levels of continence had not been achieved due to inconsistent staffing and staff shortages. Through examination of incident/accident records, it was identified that a number of assaults on staff and other service users had taken place in one of the bungalows. No behaviour management plan was in place for the individual concerned and, although staff have to physically intervene with a service user when an assault is taking place, the nurse in charge reported that no staff have received training in this area despite requests for this. In order to protect staff and service users from potential injury, physical intervention plans and training in accordance with Department of Health guidance must be provided to staff. Risk assessments in this area need to be more detailed so that staff are clear about the actions required to minimize identified risks. The nurse in charge at bungalow 2 reported that none of the individual care plans and risk assessments were up to date as there had been insufficient time for this to be completed due to staff shortages. Most of the risk assessments that were examined were of a good standard and gave clear instructions to staff about what steps should be taken to minimize identified risks to service users. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,17 The staffing levels within the home unacceptably limit the lifestyles of service users. Service users are provided with a varied, balanced diet. EVIDENCE: Service users’ needs in respect of their lifestyle are identified as part of a person centred planning approach and this is positive. Some service users attend the day service provided on site by St Anne’s whilst some attend day services or college away from Oxfield Court. There are limited opportunities for some service users to go out apart from day services because of the staffing levels. It was noted within service user records that agreed objectives in respect of leisure and occupation were often not achieved due to staff shortages. Examples of this are: a service user did not achieve the objective of going swimming three times in a year; the same service user was not supported to go for three short walks a week. Through examination of records and discussion with staff and service users, it was apparent that service users’ needs are often not met in this area. Staff shortages are reported to impact Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 12 upon the opportunities that service users have to access the community and take part in valued and fulfilling activities. Service users in the home during the inspection were observed to spend a lot of time without occupation while staff were busy with domestic or administrative tasks. The home has access to four vehicles; two mini buses and two people carriers, and service users contribute their mobility allowance to cover the cost of this. Staff reported that often there are not enough drivers available, or the vehicles are not available when required; staff reported that they have to book the vehicles well in advance. Some staff are not confident about driving the mini buses therefore further reducing opportunities for service users to access activities in the community. The registered manager reported that she is encouraging staff to access public transport with service users if this is appropriate. Some service users have been supported to go on short break holidays away from the home. Staff reported that the service users benefited from this opportunity. Menus examined demonstrated that a balanced and varied diet is offered. The menus showed that vegetables are offered daily, though there was less evidence to show that fruit was offered regularly. On the day of inspection, service users in house 10 had chicken casserole, mash and cabbage for lunch. A service user told the inspectors that she enjoyed the food that was offered. As recommended at the last inspection, mealtime guidelines have been removed from the front of kitchen cupboards so as to protect the privacy of service users. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 Health care support is generally good but needs to be monitored to check all service users’ needs are being met. Medicine management needs to improve in some of the houses. EVIDENCE: Within most of the service user records that were examined, there was evidence that routine health screening checks had been carried out at the appropriate intervals. However, some records indicated that appointments had not been made when they were due. For example, a service user’s file stated in 2003 that the next optician appointment was due in May 2004. There was no evidence to suggest that this had been arranged or attended. The recommendation that all service users’ files be reviewed to ensure that routine health screening is up to date is, therefore, repeated. Some service users have health action plans in place that are reviewed annually and this is positive. Medication records and storage were examined in three houses. In one house, all medicines tallied with records kept, however in two houses there were signature omissions, discrepancies in running balances and some prescribed Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 14 preparations (eye drops and ‘Thick and Easy’) had not been administered as prescribed. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The home has a clear complaints procedure that is available to service users and their relatives. Service users are not always adequately protected from harm. EVIDENCE: No complaints have been received at this home since the last inspection. A satisfactory complaints procedure is in place that was displayed in the entrance hall in some of the houses. Robust procedures are in place for the protection of vulnerable adults. A physical intervention policy and procedure is available that is in line with Department of Health guidance. The inspectors were concerned that a number of serious incidents of aggression had taken place in one of the houses whereby staff had been forced to physically intervene with a service user on a number of occasions, and no agreed behaviour management plan or physical intervention plan had been developed. This is unsafe practice that puts both service users and staff at risk and is not in accordance with guidance from the Department of Health. The nurse in charge reported that staff have not had any training in the implementation of physical intervention or the management of violence and aggression which increases the risk of harm to service users and staff. This must be addressed as a matter of urgency. This was discussed with the nurse in charge at the time of inspection. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,29,30 Service users live in a generally clean and comfortable home. A good range of equipment is provided to maximise independence and safely move and handle service users although some of the equipment needs to be repaired or replaced. The heating and hot water systems at this home need to be improved. EVIDENCE: A tour of the premises was conducted in four of the five houses including all communal areas, laundry, kitchens and a sample of bedrooms. Most areas seen were clean and tidy. Most service users’ bedrooms are decorated to a high standard, and staff reported that they have supported service users in choosing the décor. A lot of the furniture and furnishings in service users’ bedrooms had been purchased with their own money, including beds, fitted wardrobes, bedding, and curtains. It was noted that the furniture in one service user’s bedroom was in poor condition; nails were sticking out on the drawers. Staff reported that the service user didn’t have much money and therefore had ‘hand me down’ furniture. The registered provider must ensure that all service users are provided with adequate furniture that is in good condition. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 17 The heating and hot water system throughout the houses continues to be problematic. Some areas did not have hot water whilst the temperature from some hot water outlets was excessively high. Staff reported that the heating was erratic and that the system did not provide consistent heat. This is said to have been reported to the maintenance department following the last inspection. The provider must take steps to ensure that adequate heating and hot water are available at all times. The manager in house 10 reported that there had been no shower for around ten weeks as the floor was being replaced. This is reported to have caused difficulties, as there is insufficient hot water for all service users to have a bath. Most parts of the houses were clean and free from unpleasant odours. A range of moving and handling equipment is available in the houses although some needs to be repaired or replaced. This was pointed out at the last inspection, and the manager explained that this has been reported to maintenance. It was noted that the lounge carpet in house 8 was badly stained and in need of replacement. The manager reported that they had arranged to have a quote for a replacement. One service user’s bedroom had a damp patch on the ceiling that needs to be addressed; this was pointed out to the manager of the home at the time of inspection. Since the last inspection, liquid soap and paper towels have been provided in all the toilets, bathrooms and laundry areas. Sluice cycles are available on the washing machines and the red bag system is used for laundering soiled items. A locked COSHH cupboard is in each of the laundry areas. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 Some members of the staff team have relevant qualifications and have attended the required training. Further training is necessary for a number of staff. There is not always enough staff on duty to meet service users’ needs in all areas. Service users are protected by the home’s recruitment practice and procedures. EVIDENCE: Most staff were observed to be approachable and comfortable with service users. Some staff have the skills and experience necessary for the tasks they are expected to do, however a number of staff have not received relevant training in some areas. As previously discussed in this report, staff have not received training in challenging behaviour and the management of violence and aggression. This is particularly important for some staff who are expected to physically intervene with service users and de-escalate incidents of aggression. A significant number of staff have not received training in abuse awareness, fire or movement and handling. The provider offers a comprehensive training programme, however records suggest that some staff from Oxfield Court are not attending this training. The registered manager must address this area. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 19 Although some staff have completed NVQ level 2 or above, the home has not achieved the 50 target as set out in the National Minimum Standards. Oxfield Court has a registered manager who has responsibility for the five houses and also manages the on site day service. The registered manager was not on duty at the time of inspection. Each of the houses has a qualified home manager and a team of support staff. At the time of inspection, three qualified nurses were on duty to cover the five houses. Staff at Oxfield Court work 12 and a half hour shifts for 3 days followed by four days off. Staff reported that they preferred this shift pattern although said that the shifts were tiring. Some of the houses are fully staffed whilst some have a number of vacancies and staff on long-term sick leave. Service users’ opportunities to access activities out of the home are limited due to insufficient staffing levels or a lack of drivers. Some service users require two staff to support them whilst out of the home and staff reported that this also impacts upon opportunities offered. In one of the houses, a service user requires two staff to support with his personal care routine that can take up to an hour. The nurse in charge explained that this results in the service user often not being supported to get up until lunchtime as staff are busy supporting the remaining five service users. In this house, there are three staff on duty in the morning and two staff in the afternoon. When there are only two staff on duty, service users are left unsupervised for lengthy periods of time while the staff are supporting one service user. It is recommended once again that a review of staffing levels be conducted and necessary adjustments made to make sure that service users’ needs are met in all areas. Staff recruitment records are to be checked centrally by the Provider Relationship Manager from CSCI. The home holds a checklist confirming that all the required information has been received prior to staff starting work at the home. There was evidence in records that an induction is completed. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 Service users benefit from living in a home that is managed by an experienced, qualified, registered manager. Satisfactory quality assurance and monitoring systems are in place at this home although a system for publishing the results needs to be developed. The health and safety of service users and staff are well protected in some areas though not in others. EVIDENCE: The registered manager is a first level registered nurse (learning disabilities), has the Registered Managers’ Award and has many years’ experience of working at a management level in nursing care homes. Questionnaires are sent to relatives/friends of service users seeking their views about the quality of service offered although the results of the questionnaires are not published or made available to service users or other interested parties; a requirement has been made in respect of this. The home has an annual development plan that is available in the home. Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 21 Maintenance and fire safety records were examined in bungalows 8 and 10. All were found to be up to date and in good order. There was evidence that fire safety checks and servicing of movement and handling equipment are conducted at the required intervals. General risk assessments are in place covering a range of health and safety matters. Since the last inspection, the damaged shower chair has been replaced, however some of the grab rails identified as being unstable and potentially a hazard to service users still need to be repaired or replaced. To reduce the risk of scalding, the hot water system must be repaired to ensure that hot water is delivered close to 43°C. Since the last inspection, incidents and accidents have been reported to the CSCI as required and in line with regulation 37 of the Care Homes Regulations 2001. Many of the records examined were up to date and in good order, however, as previously mentioned in the report, some records require further development and clarity. In order to protect the health and safety of service users and staff, appropriate training in the management of challenging behaviour and safe use of physical intervention is required. Oxfield Court Nursing Home DS0000001124.V271224.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 Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 1 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 1 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 X X 1 X LIFESTYLES Standard No Score 11 X 12 1 13 1 14 1 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 1 X 3 X 2 X 1 1 X Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 23 Yes 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 YA6 YA18 YA23 YA41 Regulation 15(1)(2)(b)(c)(d) Requirement 12(1)(b) A current individual care plan that includes personal support plans, behaviour management plans and physical intervention plans (where appropriate) must be in place for service users accommodated at the home. This must be kept under review and must be implemented as agreed. Detailed risk assessments must be in place for all service users. Risk assessments currently in place must be reviewed to ensure they contain sufficient detail. 12(1)(b) The registered person must make arrangements for all service users living at the home to have regular access to community activities and recreational and daytime DS0000001124.V271224.R01.S.doc Version 5.1 Page 24 Timescale for action 15/04/06 2. YA9 YA41 13(4) 15/04/06 3. YA12 YA13 YA14 16(2)(m)(n), 15/04/06 Oxfield Court Nursing Home 4. YA20 13(2) occupation/education opportunities consistent with their interests and wishes. Accurate medication records must be kept in the home. Medication must be administered as prescribed. 31/03/06 5. YA23 YA32 YA35 13(6), 18(1)(c)(i) 6. YA24 YA42 7. YA29 YA42 YA24 8. All staff must be provided with appropriate training including fire, movement and handling, adult protection, health and safety and training specific to challenging behaviour, by an appropriately qualified trainer. All staff expected to physically intervene with service users must have undertaken a recognised and accredited course. This must be kept up to date, follow best practice guidelines and be specific to the needs of the individual service user. 13(4)a 23(2)b c The heating and hot water system must be repaired to provide sufficient and suitable heat and hot water delivered close to 43 degrees centigrade. 07/01/06 unmet. 13(4)(a)23(2)(c) Grab rails identified as being unstable must be repaired or replaced. 31/12/05 unmet. 16(2)(c)23(3)(b)(c) The registered person must ensure that the care home is kept in a good state of repair and is kept clean and reasonably decorated. Adequate furniture and other DS0000001124.V271224.R01.S.doc 30/04/06 15/04/06 31/03/06 15/04/06 Oxfield Court Nursing Home Version 5.1 Page 25 furnishings as detailed in regulation 16(2)(c) must be provided. Therefore the carpet in house eight must be replaced, the source of the damp patch in a service user’s bedroom must be established and repaired, and unsafe furniture in a service user’s bedroom must be repaired or replaced. 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 YA6 YA41 Good Practice Recommendations The planning tools used should be standardised across the service and detailed plans should be available for each individual service user. A review of staffing levels should be conducted and necessary adjustments made to ensure that service users needs are met in all areas and service users are enabled to access community based activities more frequently. All service users’ healthcare needs should be reviewed to ensure they are receiving routine health screening checks. The registered person should continue working towards 50 of all care staff achieving NVQ level 2 or above. 2. YA33 3. 4. YA19 YA32 Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Oxfield Court Nursing Home DS0000001124.V271224.R01.S.doc Version 5.1 Page 27 - 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. 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