CARE HOME ADULTS 18-65
Palmwood Court Care Home 14/17 Palmwood Court, Highbury Vale Bulwell Nottingham NG6 9BZ Lead Inspector
Joanna Carrington Key Unannounced Inspection 6th February 2007 10:00 Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 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 Palmwood Court Care Home DS0000002238.V306488.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 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. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Palmwood Court Care Home Address 14/17 Palmwood Court, Highbury Vale Bulwell Nottingham NG6 9BZ 0115 916 9334 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) myvonneh@ncha.org.uk Nottingham Community Housing Association Mrs Yvonne Hughes Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. To allow one named service user of 67 years of age to reside at Palmwood Court Service users shall be within category MD Date of last inspection 8th December 2005 Brief Description of the Service: 14 / 17 Palmwood Court is a purpose built care home registered to provide personal support and accommodation for up to twelve adults with a mental health difficulty. There are three bungalows in total each accommodating four residents with one bungalow being all female and another being all male. There is another bungalow for the admin office and staffroom and a communal lounge for all residents and staff to come together. Each bungalow has its own kitchen and bathroom facilities as well as a private garden that residents are actively encouraged to maintain. The home is located in a quiet cul-de-sac in the residential area of Bulwell and is close to local amenities and bus routes into Nottingham City Centre. The fees for accommodation and support are £300 per week. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the home’s key inspection and took place over seven hours on 6th February 2007. The main method of inspection was called ‘case tracking’ which meant selecting three residents and tracking the quality of their care by checking records, discussion with them and with staff and observation of care practices. Altogether, three residents and two staff members were spoken with during the course of the inspection. Staff records were looked at to make sure staff get the training they need. A partial tour of the premises also took place in order to assess environmental standards. Information obtained prior to the inspection, mainly in the preinspection questionnaire has also been used to inform judgements about the service. The registered manager was available for discussion and feedback throughout the inspection. What the service does well: What has improved since the last inspection? Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 6 There have been improvements to the way clients are involved with their care plans. They now keep a hard copy with their service user guides. This means clients can have more of a say in how their care is delivered. Care plans have been developed for clients that have some assistance with their personal hygiene, which ensures support is consistent and carried out in the way each individual client wants. Clients that have assistance with their finances and with their smoking also now have care plans in place. This is important because again it ensures staff are supporting individuals in the same way and in an ethical way, that does not impinge on their rights. Staff are getting regular supervision, a vital part of their support, which ultimately benefits the service clients get. There have been some changes to the environment. Kitchens have been refurbished and supplied with new equipment, and some parts of the home have been redecorated and re-carpeted. What they could do better:
Although staff reported that they are up to date with their mandatory training and are happy with the level of training they receive there is not sufficient evidence in the home to indicate that staff are receiving all necessary training to meet the collective and individual needs of clients. The home could do better by keeping copies of certificates and maintaining a central record. There is still not the required staff information held at the home. This does not allow the Commission to regulate the service in whether or not the necessary pre-employment checks are carried out. The registered provider must ensure that either the information is held at the home or that it is held at their head offices, so that an unannounced inspection can be made there to check these records. When clients have been involved in the review of their care plans then it is advised this is evidenced. The use of daily records could be done better by ensuring that informal records made for handover, which is essential information concerning the needs of clients, are transferred onto the SuRe system. This is to ensure no information gets lost and ultimately that the needs of clients continue being appropriately met. As well as regular competency assessments for medication administration, further training in this area should also be considered for individual staff, where a need is identified. There have been incidents where clients are not abiding by home rules by smoking in their bedrooms and placing residents at risk. As long as this rule is based on a current risk assessment, if this rule is being persistently broken and concerns regarding safety are growing then further action in terms of
Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 7 individuals’ placements must be considered. This is to ensure the health and safety of all clients living in the home. 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. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 8 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 Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 9 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): 1, 2 and 5 Quality in this outcome area is good. Admission arrangements are good in ensuring that the home is suitable for prospective clients. Prospective clients have enough information about the home to choose to live there and do not move to the home until their needs have been assessed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All three clients spoken with confirmed that they own a copy of the Service User Guide. This contains a copy of their contract. It is recommended that this contract be renewed so that it reflects the current level of fees. Clients are entitled to know how much it costs for them to live there and how the fees are being paid. For all three clients that were case tracked there is a copy of their Health and Community Care Assessment retained on their file. This assessment is essential for determining whether the home is appropriate in meeting their individual needs and then forms the basis for support plans. The needs of clients are assessed regularly in line with the Care Programme Approach. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 10 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, 7 and 9 Quality in this outcome area is good. There are good arrangements in place for ensuring that the needs and choices of clients are met. Risks are appropriately managed which promote clients’ safety and also their right to independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Some real improvement has been made with clients’ access to care plans. All residents spoken with confirmed that they hold their own printed copies in their bedrooms. Care plans are stored electronically and the system showed that they are reviewed at least six monthly, usually more depending on the need. It is still recommended that key workers evidence when they have discussed any changes to care plans / when they are reviewed. Even though a client spoken with did say they are happy with the content of care plans and how support is given the client also reported that she had not spoken about her care plans with her key worker for a long time. There are now care plans in place that identify when residents have some support with their personal hygiene. This makes sure that the staff team provide consistent support that meets with residents’ preferences.
Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 11 Some daily records were seen, which are written by hand. The registered manager explained that these notes are for ensuring staff coming on shift are handed over all necessary information. These notes cannot be retained in this format because they do not meet with data protection. Some entries seen were about continence and mobility but there was no record of this transferred on to the electronic system, where formal documentation is kept. This means that important information about a resident’s needs may get lost. Clients receive support with managing their finances and cigarettes if this is what they want. One of the main risks in the home is clients’ smoking, for which there are detailed and both generic and individualised risk assessments in place. It was evident from both discussion with staff and from the written risk assessments seen that clients are supported to make their own decisions in their lives and to take acceptable risks in order to retain their independence and quality of life. Clients spoken with also confirmed that they feel in control of their lives and have their right to freedom. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 12 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, 15, 16 and 17 Quality in this outcome area is excellent. The rights and responsibilities of clients are respected and upheld, including the right to maintain and form relationships and to be a part of the local community. There is an excellent commitment from the team to provide meaningful and therapeutic activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a wide range of organised group activities that clients can access in the home; these include a gardening group, relaxation group, men’s and women’s groups and the ramblers group. On the day of the inspection the local chaplain was visiting to lead the women’s group. The chosen activity was baking jam tarts. The chaplain visits weekly to speak with clients about spirituality and to help people express their religious beliefs. There is also a ‘whispers’ group, which is open to the community and to residents of other homes, to share ways of coping with mental illness. Leaflets about the group are handed out to local libraries and doctors’ surgeries. There is also a carers’ forum. A staff member is the link worker for this forum and meets with informal carers and relatives on a monthly basis. A staff
Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 13 member spoken with said that this process helps relatives still feel a significant part of their relative in care’s life and family and friends are invited along to the ‘social group’. Clients that were spoken with confirmed that their friends and family visit when they want and are always welcome. Menu records are much improved since the last inspection and show a variety of healthy nutritious meals. The week of the inspection there has been beef casserole, mixed grill, roast chicken and the chip shop, a regular favourite. Records also show that there are vegetarian alternatives and clients with diabetes are provided with low sugar alternatives. Clients spoken with said they like the meals and are consulted on a weekly basis on what they fancy. Staff were observed interacting with clients in a meaningful and respectful manner and it was also evident from discussion with staff, and from the content of support plans and risk assessments that the rights of clients are acknowledged and respected at all times. Clients spoken with also confirmed this. Clients have unrestricted access to the home and can choose when they wish to spend time alone or be in the company of others. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 14 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): 18, 19 and 20 Quality in this outcome area is good. Clients’ health and personal care needs are well met and medicine management in general has improved and promotes the safety of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans seen show clients that require some assistance with their hygiene and personal care now have care plans in place that specify the level of support to be given and individuals’ preferences. Occupational therapists have been involved in assessing clients for equipment that will enable them to manage their personal care more independently and to mobilise more safely. Assessments were seen on clients’ files. The care plans and daily records seen also indicate that healthcare needs are well attended to with regular appointments to the dentist, optician and chiropodist. Staff spoken with reported that they have had some very useful assistance by the Specialist diabetes nurse in how to support a client with this condition. There is a risk assessment in relation to the resident controlling their diabetes. It is recommended that a specific care plan on the management of diabetes also be developed, with the client, in order to promote the client’s responsibility in this.
Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 15 Drugs of clients’ case tracked were audited. The instructions on the medication administration records (MAR) were clear and correlated with medicine labels. There were no gaps on the MAR records, which was a problem at the last inspection. All clients now have very detailed medication profiles that include side effects and a medication history from when clients have been in the mental health system. A staff member spoken with explained how clients are spoken with about the side effects of their medication. One of the staff files selected was for a staff member that is responsible for administering medicines and this file contained competency assessments for medicine administration. In addition to this, in line with the National Minimum Standards it is recommended that staff undertake regular training in the safe administration of medicines. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. The Complaints Procedure ensures that service users views are listened to and acted on. Staff know their responsibilities in line with safeguarding adults procedures, which helps ensure clients are protected from abuse. This judgement has been made using available evidence including a visit to this service EVIDENCE: There is an appropriate complaints procedure, which is displayed on notice boards and included in the Service User Guide. It is apparent from discussion with staff and from minutes of clients meetings that they are involved in the day to day running of the home and that the views of clients are listened to and acted on. Clients spoken with confirmed they know of the Complaints Procedure and that they feel confident any concerns passed on are taken seriously and acted on. There have been no allegations or disclosures of abuse made since the last inspection. Staff spoken with demonstrated an understanding of their responsibilities in protecting clients from abuse and whistle blowing. Staff correctly answered questions on what they should do if a client discloses abuse or they witness abusive oppressive practice. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is good. The environment is clean, homely and comfortable for clients. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On a tour of the premises the registered manager indicated what changes and improvements have been made to the home since the last inspection: The kitchens in bungalows 15 and 17 have been refurbished. Bungalow 17 has also had a new carpet in the hallway and flooring in the toilet. A client that is a wheelchair user is due to have his door widened so that he has better access in and out of his bedroom. The communal bungalow, where people from all three bungalows can meet and participate in activities has been repainted. The bedrooms seen are personalised to suit individuals’ taste. Clients’ spoken with confirmed they have a say in how their bedroom, and the home overall is decorated. It is recommended that for bedrooms where a new heater has been installed and the paintwork is a different colour where the previous
Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 18 radiator was, are prioritised for redecorating because this does not look pleasant or homely. Overall the bungalows appear clean and hygienic. A rule of the home is that clients are permitted to smoke in the lounges but for safety reasons not in their bedrooms. It was evident during the inspection that not all clients are abiding by this rule, and notifications have been received in the past where fire alarms have gone off. The bathroom in one of the bungalows has been badly damaged by cigarette burns. There is a detailed fire risk assessment in place that pays particular attention to this problem. In addition to this, where residents are not abiding by the terms and conditions of their placement and placing other clients at serious risk then to ensure the health and safety of all clients the appropriateness of those residents’ placements needs further consideration. It is recommended that information about the home include rules about smoking and that clients’ smoke in their lounges. This is information that a non-smoker needs to know to decide whether the home is still suitable for them. The atmosphere in the bungalows was found to be very smoky at times during the inspection. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 19 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, 34, 35 and 36 Quality in this outcome area is adequate. Clients’ benefit from an effective staff team but better evidence will help in establishing if they are appropriately trained. It is of serious concern that evidence has not been made available to indicate that recruitment checks protect service users. This judgement has been made using available evidence including a visit to this service EVIDENCE: All staff spoken with said that they get good training, which includes mandatory training such as moving and handling, basic first aid, and food hygiene then there are other courses essential for meeting the needs of service users. One staff member talked about a relaxation course, and recently attending a loss and bereavement course, which she reported getting a lot out of. It is recommended that copies of certificates of training be added to staff files because there is lack of evidence. All but one staff member are qualified to at least National Vocational Qualification (NVQ) level 2 in Social Care. All staff spoken with reported that they get good support from management in carrying out their role. There are regular supervisions, where individuals’ can talk about their development needs and any personal issues. Supervision records were seen on the staff files selected. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 20 Evidence of recruitment checks and proof of identity are still not retained at the home but are held centrally with the Trust, despite this being a repeated requirement. In order to satisfy the Commission that the care home regulations are being met three staff members were selected and a request was made for evidence to be supplied to the Commission by a set timescale. This information was not made available. Since this inspection was performed the Commission have wrote to the registered provider outlining future arrangements for the location of these files. The registered person will be required to either ensure that copies of this information are held at the home or at their head office (The registered provider’s head office, not just at the central office of the Healthcare Trust) so that these files can be accessed. If this requirement is not met then enforcement action will be considered. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 21 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 and 42 Quality in this outcome area is good. The home is well run and in the best interest of clients, but this will be improved if their own procedures for quality assurance are followed. The health, safety and welfare of clients is promoted and protected. This judgement has been made using available evidence including a visit to this service EVIDENCE: Evidence throughout this report indicates that the home is well run and that there are good outcomes for clients. Clients spoken with confirmed that they feel consulted over the running of the home. There are regular house meetings and a local advocacy group visit the home to discuss any issues concerning or affecting the clients. The registered provider’s policy for quality assurance is that three internal audits are carried out on specific aspects of the service per year. A quality assessor carries out these audits, which is a manager of another Nottingham Community Housing Association (NCHA) home. The last quality audit carried out at the home was in 2005. There was evidence in the form of emails seen
Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 22 to indicate that another quality audit is being planned. It is recommended that the policy and procedure for quality monitoring be reviewed because it is evidently not being put into practice. There is a detailed fire risk assessment in place for the home and the fire log shows that all necessary fire tests and instructions are being carried out. Fridge and freezer records are being monitored on a daily basis, which is important for food hygiene. The pre-inspection questionnaire indicates that the testing of equipment is all up to date and there are appropriate measures in place for the prevention of Legionella. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 3 X Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 8. Standard YA34 Regulation 17(3)(b) Requirement All items as specified in Schedule 2 must be kept in the care home otherwise internal arrangements are in place so that staff files are made available for inspection. This is repeated from the previous inspection, initial timescale 31/01/06 not met. Timescale for action 31/03/07 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. 4. Refer to Standard YA6 YA6 YA20 YA24 Good Practice Recommendations Include evidence in care plans when clients have been involved in their development and review. Ensure all relevant information about clients’ needs is recorded officially, in order to ensure any changes in needs and subsequent care plans are identified. Ensure staff members responsible for administering medication have regular training updates on the safe handling of medicines. Consider further action and the appropriateness of clients’ placements, when based on a current risk assessment, clients are persistently not abiding by rule not to smoke in
DS0000002238.V306488.R01.S.doc Version 5.2 Page 25 Palmwood Court Care Home 5. 6. YA35 YA39 their bedrooms and consequently are placing other clients’ at risk. This is to promote and protect all clients living in the home. Ensure there is sufficient evidence at the care home of all training and qualifications of staff. The registered provider should review policy and procedures for quality assurance, to ensure that effective quality monitoring is in place. Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Palmwood Court Care Home DS0000002238.V306488.R01.S.doc Version 5.2 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!
