Inspection on 22/12/05 for Paddock House

This inspection was carried out on 22nd December 2005.

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

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

Other inspections for this house

Paddock House 01/08/07

Paddock House 09/08/06

Paddock House 07/09/05

Paddock House 09/02/05

Paddock House 11/08/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Paddock House Wellington Road Eye Suffolk IP23 7BE Lead Inspector Jane Offord Announced Inspection 22nd December 2005 10:00 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 Paddock House DS0000037493.V263328.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. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Paddock House Address Wellington Road Eye Suffolk IP23 7BE 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) 01379 870440 01379 873332 Suffolk County Council Mrs Elaine Margaret Hyde Care Home 30 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (20) of places Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th February 2005 Brief Description of the Service: Paddock House is situated in the market town of Eye and owned by Suffolk County Council. It is close to all the local shops and other facilities in the town. The service offers accommodation and care for thirty older people with ten of those places being a special needs unit. All bedrooms are single rooms with ensuite toilets and washbasins. The accommodation is on two floors with a passenger lift for access. The service is divided into three units. Each unit has its own kitchen/dining area and separate lounge. There are assisted bathrooms and toilets in the communal areas of the building. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken by an inspector accompanied by a Business Relationship Manager during a weekday, between 10:00 and 17:00. The personal files and care plans of three residents were seen, the files of three staff, the complaints log and accident/incident log, staff rotas and certificates for checks carried out on equipment and fire precautions were all examined. A medication round was observed and the medication procedure was seen. Medication Administration Records (MAR sheets) were checked and the records of the training undertaken by staff to administer medication were seen. A tour of the home was undertaken and each unit was visited. The kitchens and laundry were seen and a number of staff, residents and visitors were spoken with in the course of the day. The manager, who had only recently rejoined the service after a six-month secondment to a different home, was available throughout the day to assist by providing files and information. On the day of inspection the home was clean and tidy and, with the exception of one bathroom and one resident’s bedroom, was free of unpleasant odours. The residents all looked well presented and comfortable and interactions between them and staff were caring and appropriate. What the service does well: What has improved since the last inspection? Although some omissions in the medication administration procedure were noted at this inspection the service has made big efforts to comply with the previous requirements from the last inspection and the pharmacist’s inspection. Medication practice is much safer than at the last inspection. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 6 The requirements to offer staff training in supporting people with a diagnosis of dementia and Protection of Vulnerable Adults (POVA) has been actioned and staff felt they were more able to meet residents’ needs. The manager has taken the initiative of employing a carer to facilitate a number of the residents regularly attending church services at the local church. 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. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 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 the following standard(s): 3, 4, (Standard six does not apply to this home.) People who use this service can expect that they will have a pre-admission assessment of their care needs and assurance that they can be met prior to admission. EVIDENCE: Three residents’ files were inspected and all included evidence of a comprehensive pre-admission assessment. It covered areas of personal care and physical needs such as diet, sight, hearing, continence and mental ability. There was additional information recorded about family contacts, social interests, communication and past medical history. The resident’s current medication was recorded together with a history of any falls. A requirement from the previous inspection that all staff that worked in the special needs unit must have training in caring for people with dementia had been actioned. Two carers spoken with had received recent training and felt they were better able to meet the needs of residents admitted to the service with a diagnosis of dementia. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 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 the following standard(s): 7, 8, 9, 10 People who use this service can expect to have a care plan identifying their health and personal care needs but cannot be assured that their psychological needs will be addressed. They can expect that they will be treated with respect but cannot be assured that the home’s policies for administering medication will always be followed. EVIDENCE: The three residents’ files and care plans seen addressed assessments and interventions for a range of care needs. Each file had a photograph of the resident, a life story, past medical history, contact details for the next of kin and the residents religious beliefs, if any. There were a number of assessments in each file covering tissue viability, nutrition, moving and handling, continence and night care needs. One of the files had details of the resident’s final wishes. The manager said that this is a sensitive area and one in which the information may be gleaned over a period of time. Addressing it at the time of admission was not appropriate unless the resident or relatives raised the subject. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 10 Each file had a record of health professionals involved with the resident and the visits they had made for example to the opticians, the chiropodist, the GP and the community nurse. One resident said that they had had their leg dressings renewed that day by the community nurse. There were a number of individual risk assessments for areas of care such as unpredictable behaviour, using a wheelchair, managing room keys, getting lost in the town and managing the use of alcohol. In addition there were monthly weight records, changes in medication or other aids i.e. continence pads, and falls. There was evidence that the care plans were reviewed monthly. One care plan for supporting a resident’s nutrition needs recorded ‘likes to eat with other residents not alone’. One care plan had recorded a specific continence aid as a ‘nappy type pad’. That terminology is unacceptable. No care plan seen had any emotional or psychological interventions recorded. The senior staff are responsible for administering medication. It was evident from senior staff meeting minutes that they had undertaken training on medication administration on 9th November and 7th December 2005. The lunchtime medication round was observed. Following on from the pharmacist inspection of the home staff are now recording the time when medication has been given. For one resident the medication administration record (MAR sheets) recorded the medication be administered as directed by the doctor. The directions on the bottle also stated the medication be administered as directed by the doctor. The resident was given an amount of this medication by staff as, the staff member said, they always had this amount. The medication for another resident was noted not to have been signed as given on the morning of the inspection, although staff confirmed it had been given. A system for recording the administration of topical creams has been established in that these are administered by and signed as given by care staff. Not all medication had been signed as either given or refused. The home has a policy for the covert administration of medication. Staff stated, however, that medication is not covertly administered to residents. If it were the GP would be asked to indicate this on the MAR sheets, and all those involved would be asked to sign agreement with this. Risk assessments had been completed for residents who self medicate. One had not been countersigned by the line manager or the resident or their advocate, although the other had. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 11 There was evidence of audits of the medication records. Night staff carried these out on 12th December and 19th December 2005. Staff were observed addressing residents respectfully and offering them choices about where they wanted to spend their time or which dessert they would like. Residents have access to a portable telephone that can be plugged into a socket in their own room to maintain privacy of calls. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 People who use this service can expect to maintain contact with family and friends and be given the choice of a wide menu of well-prepared meals however they cannot be assured that they will be offered sufficient activities and recreational pastimes to keep them stimulated. EVIDENCE: Residents’ personal files all contained contact details for their next of kin or close friends. There were records of people who had visited and whether the resident had been out with a visitor. There were visitors at the home on the day of inspection. Seventeen comment cards were received from relatives and visitors prior to this inspection. All of them said that they were welcome at any time. In addition to ticking the appropriate box two made written comments. ‘We visited the home today and found the staff pleasant… and so welcoming’. ‘A friendly home. We were made to feel very welcome’. A visitor to the home confirmed that they could visit when they wished. Residents and a relative spoken with were positive about the home and the support provided by the staff. One resident said it was the next best thing to being in their own home. The relative of another resident confirmed that their relative was happy at the home. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 13 Since the last inspection the manager has employed a carer to facilitate a number of residents attending the local church on a Sunday. The residents said that they had been attending regularly and were looking forward to the Carol service. One resident said they were going to spend Christmas with a relative who lived nearby. There was photographic evidence around the home of outings that had been arranged during the year. A number of residents had visited Thornham Walks in the summer. One resident talked about a recent visit to Bressingham Gardens and cafeteria for a Christmas lunch. On the day of inspection the hairdresser was visiting the home. A list of prices was in evidence on notice boards throughout the home. They said they have residents who they see regularly. The hairdresser confirmed that they had the appropriate insurance cover but could not recall having had a Criminal Records Bureau (CRB) check undertaken. When this was raised with the manager at the end of the inspection they confirmed that the hairdresser did have a CRB check. Staff spoken with said there was a programme of activities that they were responsible for arranging but they did not always have sufficient time to do so. Although they recognised the importance of offering meaningful activity to the residents they had to prioritise their work and physical care needs took precedence. One carer said they wished they had more quality time with residents. They were aware of some residents who did not want to leave their room and made a point of spending a few minutes with them whenever they were on duty. Lunch was served either in the dining rooms or in individual’s own room depending on their preference. Festive table decorations made by the residents were evident. A menu was available on each table, with the choice of the day written on a blackboard on the wall. The writing of this was small and difficult to see. Residents were given a choice of main courses and a choice of pudding. Vegetables were served in dishes put on the tables so residents could help themselves. It was evident that special diets such as diabetic diets were catered for as required. The meal on the day of inspection was pork in gravy with stuffing, potatoes and fresh vegetables. One resident had preferred to have an omelette and salad. Dessert was ‘spotted dick’ and custard with an alternative of jelly and blancmange or cheese and biscuits. All the dishes looked attractively presented and residents said it was a nice lunch. There were plenty of drinks available in the dining rooms and in residents’ own rooms. Residents were offered the choice of puddings and in the special needs unit residents were shown the food so they could make an informed choice. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 14 The kitchens were visited and the chef showed the Christmas, Boxing Day and New Years Day menus. They had been printed, laminated and decorated with holly and ivy leaves ready to go on the tables. Paddock House DS0000037493.V263328.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, 18 People who use this service can expect that any complaint will be taken seriously and investigated thoroughly and that they will be protected from abuse. EVIDENCE: Since the last inspection there have been seven informal complaints recorded in the log. Four of them relate to two residents who have challenging behaviour and can become verbally abusive to staff and other residents. A further two relate to minor cleaning issues and the final complaint is about a resident being got up late in the morning. All complaints had a written outcome and action taken. The manager said that since the last inspection, when two complainants told the inspector that they were not given a full explanation of the outcome of their complaint, they have written formally to all complainants. Seventeen comment cards were received from relatives and visitors. None had made a complaint and only two were not aware of the home’s complaint policy. A copy of the complaints policy was available at the entrance to the home. All ten residents who completed a comment card knew whom to contact if they were unhappy with any aspect of their care. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 16 A previous requirement that all staff who come in contact with residents must have Protection of Vulnerable Adults training (POVA) has been actioned. The manager said training had been arranged for ancillary staff and the staff spoken to in the kitchens confirmed that they had recently had training and found it very interesting. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 17 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): 22, 24, 25, 26 People who use this service can expect to live in comfortable surroundings with their own belongings and the use of specialist equipment to maximise their independence, however they cannot be assured that the home will be odour free. EVIDENCE: On the day of the inspection the home was clean and tidy. All the communal rooms and a number of the residents’ rooms were decorated for Christmas and everywhere looked very festive. The building has wide corridors and doorways that can accommodate wheelchair users. There are large windows throughout giving plenty of light and looking out over gardens or, on the first floor, views of the town of Eye. The furnishings and furniture in the units were attractive and suited to the needs of the residents. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 18 The ground floor and first floor are connected by two stairways and a passenger lift. The special needs unit has a security system on all the exit doors to alert staff if residents wander. Individual rooms were attractively furnished with evidence of residents’ own possessions and taste. Their were numerous family photographs, some soft toy animals, including a nearly life size reclining tiger, paintings and televisions and music centres in rooms. Equipment for preventing skin breakdown was in use in some rooms. Special airbeds and cushions were seen. There were hoists to help people with limited mobility and bath hoists in the communal bathrooms. Radiators and pipes were all protected and the home was comfortably warm in spite of the wintry temperature outside. There were two rooms that had unpleasant odours on the day of inspection. The bathroom in Bluebell unit smelt of urine and one resident’s room smelt of vomit. The manager reported that that resident is frequently unwell and the armchair has been identified as the source of the odour. They are in the process of obtaining a new chair. The temperature of the water in the bathrooms in one unit was tested and found to be within the recommended temperature range. A temperature gauge was available for staff to monitor the water temperature. The call bell in one bathroom was tested and was responded to promptly. One resident and a relative spoken with confirmed the staff respond promptly to a call bell when it is rung. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 19 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): 27, 29, 30 People who use this service can expect that the staff are recruited correctly and trained to do their jobs but they cannot be assured that there will always be adequate numbers of staff rostered to meet their needs. EVIDENCE: The staff rota showed that there were two care staff working on the unit for people with dementia and the other two units had one dedicated member of care staff each with an additional member of staff ‘floating’ between the two units. In addition the manager had organised staffing so there was an extra care assistant on duty between 8am and 9am to help with breakfast. The manager expressed concern that the staffing levels were not adequate to meet the increasing level of dependency of the residents. They had written to their line manager expressing this concern but had not received a response. This concern was also expressed, to an extent, by a member of care staff who said that a number of residents needed two people to assist them. A number of residents and visitors said they had concerns at times about the levels of staffing. The ancillary staff rota showed there was a laundry assistant on duty from 7.30am to 12 midday and one kitchen domestic. There are two domestic assistants rostered to work from 9am to 13.00 each weekday, and one person at the weekend. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 20 The home has had a number of care assistant vacancies but these have recently been recruited to. The vacancies had been ‘covered’ using ‘bank’ staff. The manager said they have had difficulties in recruiting to a vacant domestic assistant’s post, which remains unfilled. The staff recruitment files checked showed that the home took up two references and a CRB check before staff started working in the home. Evidence of identification and declaration of medical fitness were also available. It was evident that where there was a gap in a person’s employment history this had been followed up at interview and a record made. There was no evidence on the file of the qualifications of one member of staff despite these being listed on their application form. Staff, before starting, are sent a letter advising them of their start date and that they will ‘shadow’ an experienced member of staff initially. New staff follow an induction checklist that included areas such as fire safety, handling residents’ money, communication systems and the ‘consequences of negligent behaviour’. Those checklists seen were signed by the member of staff concerned and their line manager. Since the last inspection an in-house dementia care training course has been held. The majority of care staff within the home have now attended training in supporting people with dementia. In-house training has also been held on POVA and this was attended by care staff and ancillary staff. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 21 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): 33, 36, 37, 38 People who use this service can expect to be consulted about the care given and have their health and welfare protected by the practices and policies but they cannot be assured that all staff receive adequate supervision. EVIDENCE: In the kitchens there were records of temperature checks made on refrigerators and freezers. Food delivered from refrigerated trucks also has a temperature check before being accepted. Hot food to be served to residents has a probe check. All records seen indicated that the temperatures were all within the accepted range for food safety. Food opened and stored in refrigerators and freezers is clearly labelled and coded to indicate which day it was cooked. The daily records seen were appropriate and recorded outings and visitors as well as health and care actions. The entries were not all signed with a complete signature. At times there was just a first name signed. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 22 Records and certificates were seen of checks done on equipment. Safety checks had been done on all beds during December 2005. Monthly checks are done and recorded on the lighting and emergency lighting systems. Records were seen of maintenance checks being done on wheelchairs, hoists and fire equipment. There was documented evidence of planned maintenance being carried out on the passenger lift. Staff meetings were noted to be held infrequently in the home. The last two meetings having been held on 13th April and 26th October 2005. Senior staff meetings were noted to be held monthly with the last two meetings being used to look at medication administration, which had been an area of concern at the last inspection of the home in September 2005. One member of the care staff said they had not had supervision since starting work at the home a number of months ago. However they were aware that other staff did receive supervision. It was evident from one staff file seen that concerns about individual performance were followed up. A staff member spoken with said that they did not always know if issues relating to care of residents were followed up by the senior team. They said that they sometimes raised issues that needed to be dealt with but did not always see any outcome so were not sure what action had been taken, if any. One member of staff said they felt they were a good team working at the home with good team spirit. The Certificate of Registration that was displayed at the entrance to the home correctly reflected the registration of the home. A copy of the most recent inspection report was also available at the entrance, as was a poster informing residents and visitors of this inspection by the Commission. Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X 3 X 3 3 1 STAFFING Standard No Score 27 2 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X 2 3 3 Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? Yes. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (1) Requirement The residents’ care plans must address emotional and psychological needs to offer holistic care. Provision must be made to provide a regular programme of meaningful activities for the residents. This is a repeat requirement from the last inspection. Care plans must be written using language appropriate to the client group. Medication must be signed for as administered when taken or alternatively the appropriate code used to record whether medication has been refused etc. Staff must confirm with the GP the correct dosage of medication to be given to a resident where this is not detailed on the medication. The registered person must ensure that there are adequate numbers of staff on duty to meet the needs of residents. Copies of staff qualifications must be kept on the respective DS0000037493.V263328.R01.S.doc Timescale for action 28/02/06 2 OP12 16 (2) (n) 28/02/06 3 4 OP7 OP9 12 (4) (a) 13 (2) 22/12/05 22/12/05 5 OP9 13 (2) 22/12/05 6 OP27 18 (1) (a) 22/12/05 7 OP29 19 Sch. 2 (4) 22/12/05 Paddock House Version 5.1 Page 25 8 OP36 18 (2) 9 OP26 16 (2) (k) 10 OP37 Data Protec’tn Act98 staff member’s file. All staff must be appropriately 28/02/06 supervised. The National Minimum Standard is for all staff to receive a minimum of formal supervision at least six times a year. Steps must be taken to eradicate 22/12/05 unpleasant odours in the home with particular reference to the identified resident’s room and Bluebell unit bathroom. Daily records must have the full 22/12/05 signature of the person completing the entry. 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 OP15 OP33 OP33 Good Practice Recommendations It is recommended that the use of blackboards to display main course options for meals should be reviewed to ensure they can be easily read by residents. It is recommended that more frequent regular meetings of the whole staff team should take place. Staff should ensure that the systems for communicating the needs of residents are effective. This refers specifically to when care staff raise issues with senior staff, that care staff are aware of the action taken. A review of staffing levels in relation to residents’ dependency levels should be undertaken. 4 OP27 Paddock House DS0000037493.V263328.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk 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 Paddock House DS0000037493.V263328.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!