Inspection on 11/05/06 for Paisley Court

This inspection was carried out on 11th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Paisley Court 07/06/07

Paisley Court 01/02/06

Paisley Court 07/09/05

Paisley Court 25/02/05

Paisley Court 13/07/04

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

CARE HOMES FOR OLDER PEOPLE Paisley Court 36 Gemini Drive East Prescott Road Liverpool Merseyside L14 9LT Lead Inspector .Mrs Julie Garrity Unannounced Inspection 11th May 2006 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 Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Paisley Court Address 36 Gemini Drive East Prescott Road Liverpool Merseyside L14 9LT 0151 230 0857 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) manager.paisleycourt@careuk.com Community Health Services Limited Mrs Jayne Allison Kennie Care Home 60 Category(ies) of Dementia - over 65 years of age (60) registration, with number of places Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the service is varied to accept the admission of one named service user under the age of 65 years. 1st February 2006 Date of last inspection Brief Description of the Service: Paisley Court is situated in a middle of a residential development and is easily accessible by public transport and close to local shops. At the front of the building there is a large parking area and at the rear of the property there is an enclosed garden, which service users on the ground floor can access easily. Paisley Court is a care home providing nursing care for 60 older service users who are elderly mentally infirm. Accommodation is divided into four fifteen bedded units. All bedrooms are single and have en-suite toilet facilities. Each unit has its own dining and lounge areas. Qualified nursing staff are on duty at all times. In addition a full time activities co-ordinator is employed to provide activities for service users. All beds at Paisley Court are contracted to Liverpool Health Authority as part of continuing care, resulting in all referrals made to the home are through the team of consultants at the hospitals. Thus, service users benefit from ongoing assessment from their consultant. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over a period of one day. The inspector arrived at the home at 11:00 and left at 20.15. Many of the residents have very complex needs, the inspector was unable to communicate fully with the residents and as such 6 relatives and 7 staff were interviewed. 12 resident questionnaires were sent to the home. Other discussions were held with the manager, deputy manager and two professional visitors to the home. The inspector completed the inspection by a site visit to Paisley Court, a review of records available in Paisley Court and CSCI offices, discussions with residents, relatives, visitors, staff and management. Copies of records were submitted to CSCI for review in this inspection. The inspector followed an inspection plan written before the start of the inspection to ensure that all areas identified in need of review where covered. All of the Key standards were covered in this inspection, these are detailed in the report. Feedback was given to the manager and the deputy during and at the end of the inspection. What the service does well: What has improved since the last inspection? Staff training for the use of a computerised care planning system has increased, staff spoken with felt confident to use the system and maintain records. Storage areas have been created to prevent the inappropriate usage of bathrooms for storage. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 6 The home has addressed a number of requirements from the previous report including training, records maintenance and keeping care plans up to date. 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. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 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 Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 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): 1, 2, 3, 4 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to Paisley Court. There is sufficient information and assessment to enable residents and their families to understand the care that they will receive whilst living in Paisley court. Further development is needed for residents admitted in an emergency or respite care. EVIDENCE: The home has a service users guide that details a lot of information. Smaller service user guides are being developed for each of the units. These will include photographs, information regarding qualifications of staff, layout of the unit and how to access suitable information. None of the residents have a contract with the home as all are placed directly from the Primary Care Trust (PCT). Although the contract with the PCT is in negotiation it is intended to include things such a statement of terms and conditions suitable to the resident families. A copy of terms and conditions of residency when finalised should be included in the service users guide to keep residents and their families informed. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 9 All residents in the home are assessed before the move in with the exception of emergency admissions and respite residents on a rolling programme. Although the home does the assessments once admitted to the unit they are not in a position to clearly identify that they can meet residents needs prior to admittance. The home does not have an emergency admission procedure or respite procedure that would inform best practice. The assessment process is formulated from Care UK head office and is generally very physical needs based. The manager and deputy manager try to incorporate the psychological, spiritual and mental health needs of the residents within the standard form. Both say that this is dramatic improvement over previous assessment processes. Each resident is allocated a key worker, the home attempts to make sure that the key worker is available on duty when the resident arrives. This provides continuity of care and a point of contact for residents and their relatives. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to Paisley Court. Resident individual health, personal and social care needs are not always clearly recorded and as such do not provide the staff with clear information and guidelines as to the appropriate action they need to take to care for the residents appropriately. Medication management is not following the homes own policy and as such remains unsafe. EVIDENCE: All of the residents have a care plan in place these are generated from a computerised system and are individualised for each resident. They are not printed out and can only be accessed via a password on the computer. This limits the input from residents and relatives. The key nurse reviews these on a monthly basis and the system alerts the nurse if they are not done. On examination of the care plans needs clearly identified by the staff were not recorded. An example of this included a resident whose behaviour needs had resulted in an assault on another residents. Although clearly recorded in the daily records this was not care planned for. Another example included medications prescribed on a per required needs basis, were not explored within the care plan as to when to give. A further example concerned the 1-1 care of Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 11 a resident as this was not clearly recorded staff had left the resident unattended, both the manager and the deputy detailed that this was not appropriate. One relative spoken with was aware that a computer record was maintained said, Ive no idea whats in it. Staff have recently undertaken updated training in how to use the computerised care plan system, staff spoken with found that they were easily able to update care plans on a daily basis. This had resulted in good clear daily records, which clearly accounted for how the home had met the residents needs that day. Records were kept after visits from external professionals such as doctors, consultants, dentists and opticians. This clearly described the purpose of the visit and any recommendations. The home has treated appropriately pressure ulcers in the past and at present none of the residents have pressure ulcers. At relative spoken with detailed, the care here is very good, staff are able and willing to take advice when necessary. The home has a reasonable policy and audit in place for managing medications. However the audit just covers if the paper work is complete and doesn’t review the process or competency. Records for 12 residents were reviewed and found issues with all their medications. The medications where not being given as prescribed an example included, one resident had not received all medications for a 10 am dose, one of the medications must be taken regularly with no gaps as the medication ceases to be as effective. Medications prescribed for individuals (Oxygen cylinders) where retained “just incase”, this is an illegal and potentially very dangerous practice as medications can only be given to the individual they are prescribed for. Two residents frequently spat out medications, this was not explored in the care plans and per required need medication was not detailed on either Medications Administration Records or the care plans. Care staff applied external preparations. There were no instructions available to care staff as to how, when or where they were to be applied. Staff observed was generally very courteous and addressed both the residents and their families in an appropriate manner. A number of the bedroom doors within the home remain open at all times, residents could be observed from the main corridors whilst in their beds. One of the residents was wearing very stained clothing. A relative detailed that she was reluctant to wash dress and change. None of this was detailed in the resident care plan. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 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, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to Paisley Court. The home does consult widely with the relatives of residents as resident’s medical conditions make communication limited. Staff have a wide range of knowledge regarding residents choices and preferences however none of this is recorded and therefore relies solely on staff providing accurate verbal information. EVIDENCE: Relatives spoken with the generally very complimentary about the care that the home provided. One relative said, I am always welcome, staff are friendly and approachable and very kind. Relatives meetings are available and relatives are welcome to attend as they see fit. The manager operates an open door policy, which enables resident’s relatives to approach her at any time. The majority of the residents are not presently able to express their personal point of view. The computerised system available within the home has a good section in which to record resident’s personal preferences and choices. A questionnaire regarding care and choices has been circulated to relatives and some responses have been received. However neither the questionnaire nor the computerised records have been utilised to influence residents choices, preferences or decisions. Staff have over time acquired a great deal of Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 13 knowledge regarding personal preferences of residents. This is relevant to long stay residents but is ineffective for residents on the respite unit as they stay for a very short time and staff do not have the same opportunity to explore the residents preferences. The menu within the home offers choices, when the menus are changed families and staff are consulted to try and influence the menus. The kitchen cooks 30 meals of each choice on a daily basis. There are two residents with ethnic needs and are not catered for. A care assistant is preparing specialist meals for one resident these will be accomidated within the homes menus in the future. One of the relatives spoken with said, it would be nice if she was able to have curries and dhal, it is what she is used to have liked to eat. There were regular meals provided throughout the day and supper in the evening. The supper came about as a direct result of staff stating that some of the male residents were particularly hungry in the evening. This was addressed immediately and from then soup was placed on the menu additional to sandwiches available from 7:30 onwards for residents who may still hungry. Observations over lunchtime detailed that resident’s meals were identical. Staff spoken with detailed that they made the choices for residents dependent on what they knew all the residents personal preferences. As none of this is recorded staff run the risk of making inappropriate choices. All residents case tracked had, had their weights reviewed regularly. Of the records viewed any of the residents at risk of losing weight and closely monitored. Activities records were brief, it was difficult to determine what activities residents underwent on a daily basis. The activities coordinator is attending training in maintaining the computerised system, which was identified as a need from a previous inspection. There were no activities observed during the inspection. The lack of individualised residents preferences and needs prevents staff from fully understanding the individual activities required for the residents with dementia needs. Care plans do not detailed any daily living activities promoted or encouraged by the home. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 14 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, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Paisley Court. The home has policies, procedures and training that clearly undertakes to protect residents and assist staff in raising concerns. EVIDENCE: The home has a wide range of policies and procedures that include whisleblowing, raising complaints and protection of vulnerable adults. Staff spoken with had been shown all the policies within this area. Staff were updated regularly regarding protection of vulnerable adults and how to raise any concerns that they may have. All complaints are recorded and thoroughly investigated and the responses sent to the complainant. Staff inductions includes a variety of areas such as dealing with challenging behaviour and privacy and dignity. Under discussion with the staff they all had a clear understanding of how to raise concerns. The manager and deputy have appropriately dealt with three recent incidents. A copy of the complaints procedure is available within the information in the home. Relatives spoken with were aware of the policy and how to raise concerns. A relative spoken with said I have raised concerns, theyd sorted it immediately. Another relative who was aware of where the complaints procedure was and how to raise a complaint they also said “I’ve never had any reason to”. A recent complaint from a relative had been fully investigated and appropriate external professionals contacted. The home and staff have learnt a great deal Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 15 from this experience and were putting into place actions taken from the complaint. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 23, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Paisley Court. The home is well maintained and suitable to the residents needs. EVIDENCE: The home is well maintained. The home is divided into four separate units. Each unit has a day room and a dining room available for the residents. There are ample bathrooms within the home. The home has spoken with the local fire authority and is now using space on the stairwell to help ease their storage problems. One of the units contained a smell, the manager detailed that one of the residents had become unsettled and as such the cleaning team were accommodating the resident’s needs. Each of the residents were offered an opportunity to personalise their own private space. This has included furniture and photographs, a full list of items brought in by the family is retained in the resident’s records as this enables the home to take responsibility for items that they are aware of. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 17 Many of the residents bedroom doors were left open this negated the privacy of individual bedrooms. Several of the bedroom doors had safety gates that we used to stop wandering residents from accessing bedrooms. The homes overall risk assessment, which includes a fire risk assessment, did not detail the usage of baby gates. It was also noted that none of the doors had automatic closure is in place. This too was not mentioned in the homes overall risk assessments. Make that issues are addressed upon development, on the day of inspection two maintenance man were available on site undertaking minor repairs. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Paisley Court. The recruitment policies and practices are robust and safeguard the residents. Staff training is in need of updating to make sure that staff are fully developed to met the needs of the residents. EVIDENCE: The home has full recruitment and policies a number of staff files were reviewed. These evidenced that all staff had undergone full and proper recruitment including references, police checks, P.O.V.A first checks an explanation for any gaps in their working history. The recruitment was undertaken on an equal opportunities basis that the record was maintained as a general assessment at time of interview. Training needs was difficult to identify, the deputy manager maintains a spreadsheet that lists each member of staff for the training that they have undergone. This was unfortunately out of date due to unforeseen circumstances. A number items for training were not detailed on a spreadsheet such as diabetes, Alzheimers training and other training needs identified from resident individual care plans. The number of staffs training was out of date, two staff detailed that they had not so hard up-to-date training in a number of areas. The home underwent an assessments of the residents needs to determine the correct staffing level about 18 months ago. This is good practice but should be Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 19 continued on a regular basis as the residents needs of the residents themselves will change frequently. Relatives and staff spoken with said that there was sufficient staff available. One resident said, “ staff are kind, always available and happy to care”. One resident was on a one-to-one care program, it was noted that a member of staff was not carrying out the one-to-one instructions. The staff member had been told that unnecessary when the resident was asleep. The manager addressed this at the site visit and the one-to-one care will be maintained at all times. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to Paisley Court. Management strives to develop quality at all times and is aware of the need for residents and their relatives to in put into the environment. Progress is being made in supervision and maintaining training for staff. EVIDENCE: The home has its own quality assurance scheme in place. Much of this is guided through “clinical governance” all incidents are referred to their review. Questionnaires have been sent to relatives as to their perspective of the care received and some to residents. Although replies are low some raised concerns that the manager intends to address in the near future. The majority were complimentary of the care received. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 21 The manager is registered with CSCI and has extensive experience in the care industry. Shes qualified as a mental health nurse and has a deputy with qualifications in general nursing. A good team was observed with both sharing tasks and inputting appropriately into the home. Resident and relatives meetings are held on a regular basis. Minutes of these are available for relatives to view, copies are sent to the relatives homes and posted on the notice boards in the home. Staff meetings are also held on a regular basis in which staff are updated on the care needs of residents. All staff attend a handover at the start of each duty and are kept informed of changes to residents care needs. Staff supervision is ongoing and staff spoken with confirmed that they had undertaken supervision recently. As yet they are still unsure as to the process and purpose and have not been shown a policy or guidelines. Two commented that they found it a value as it helped identify training needs and issues before the became a problem. None of the residents do not to pay for their care and as such the home does not hold personal allowances for the residents and therefore is not appointee for any of the residents. An individual account is held in head office, which contains resident’s funds, and a small amount is available on site. Residents must order large amounts of money and give a weeks notice. Access to the small amount on site is not available at the weekend as this is locked in a safe. Staff plan ahead to ensure that money is available for activities for which the residents may need them. Although the home has risk assessments for the environment, there are number of areas that are in need of further expansion these include a lack of automatic door closes on bedroom doors and the usage of baby gates within the home. The manager detailed that she would contact the fire departments for advice and guidance. All the risk assessments in need of further development include the baby gates per individual and the need for some bedroom doors to remain open all times. Certificates of maintenance were available and all up to date, maintenance records clearly detail all maintenance issues addressed. Health and safety training is available for staff, to staff detailed that they were unsure if they remained in date for moving and handling. Due to issues with the spreadsheet not all staff training records were clear. Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 X 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 X 2 Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 23 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. OP3 2. OP7 Standard Regulation 14 (1) (a) (c) (d) 15 (1) (2) (a) (b) (c) (d) Requirement Arrangements must be made that informs staff of changes in the needs of residents who return for respite. All residents care plans must fully reflect their identified needs and provide staff with clear instructions as to the actions they must take to appropriately care for the residents. Timescale for action 11/07/06 11/06/06 3. OP9 13 (2) The registered person shall make 01/06/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medication received into the care home. The management of medication at the care home must comply with current regulation and guidance issued by the Royal Pharmaceutical Society of Great Britain. And the guidelines issued by the Nursing and Midwifery Council. (Outstanding from previous report) A review of the baby gates and its impact on privacy and dignity DS0000025191.V295105.R01.S.doc 4. OP10 12 (4) (a) 11/07/06 Paisley Court Version 5.2 Page 24 5. OP14 12 (2) 6. OP30 18 (1) (a) must be undertaken. All baby gates must be risk assessed and advice sought from the fire authority Further development must be 11/07/06 undertaken to make sure that residents personal choices are obtained, used to influence the home and recorded in the system provided. A record of staff training must be 11/07/06 up dated and reflect all training needs of staff identify. Staff training must be monitored to make sure that up to date training can be planned for and provided. 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 OP1 Good Practice Recommendations Consideration should be made as to including the terms and conditions of occupancy conditions within the contract from the PCT in the homes information supplied to residents and relatives. An emergency admission procedure should be developed to assist staff with admissions of this nature. Staff make consideration to explaining to residents the food that have before they assist them to feed. The training record should also reflect all training undertaken such as application of external preparations as an example. 2. 3. 4. OP3 OP15 OP30 Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Paisley Court DS0000025191.V295105.R01.S.doc Version 5.2 Page 26 - 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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