Inspection on 18/08/07 for 339 Pershore Road

This inspection was carried out on 18th August 2007.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

339 Pershore Road 25/01/07

339 Pershore Road 18/10/05

339 Pershore Road 19/04/05

339 Pershore Road 22/09/04

339 Pershore Road 18/05/04

339 Pershore Road 12/02/04

Similar services:

Polesworth Group 68 Long Street

10 Whitfield Avenue

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 Pershore Road (339) Edgbaston Birmingham West Midlands B5 7RY Lead Inspector Deirdre Nash Key Unannounced Inspection Saturday 18th August 2007 09:30 Pershore Road (339) DS0000016885.V337868.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 Pershore Road (339) DS0000016885.V337868.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. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pershore Road (339) Address Edgbaston Birmingham West Midlands B5 7RY 0121 472 0224 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) PershoreRdOcs@aol.com Optimum Care Services Miss Desmin Hazle Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. Residents must be aged under 65 years That Desmin Hazle completes the registered Managers Award/ NVQ 4 in Care by 2005. The Home can continue to accommodate one named service user over 65 with a learning disability. That 339 Pershore Road apply for a variation on behalf of future service users who reach the age of 65. That details regarding how the specific care and social needs of people over 65 will be met must be included in the service user plan. Future admissions, and the statement of purpose be amended to reflect the age of service users accommodated. 25th January 2007 Date of last inspection Brief Description of the Service: The home is registered to provide personal care and accommodation for up to six adults who have a learning disability. All of the service users currently at the home are male. It is a detached house situated on a main road with other large, high value properties, on a bus route and fairly close to the centre of Birmingham. Accommodation for service users is provided in two single bedrooms on the ground floor and four single bedrooms on the first floor. All have wash hand basins. The home has a large fitted kitchen, a dining room, lounge, small laundry and a bathroom and shower room. The front of the house has a driveway that provides parking for several cars. The rear garden is large and has two patio areas. There are shops within walking distance of the home and Cannon Hill Park containing the Midlands Arts Centre is nearby. Fee levels for 2007/8 were requested but were not available. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We looked at all of the information that we have received about this home since it was last inspected. We sent the manager of the home an quality assessment questionnaire (AQAA) to fill out in order to bring us up to date with facts and figures about the home and what improvements have been made. This was returned to us in good time and properly completed. The Inspector called at the home without notice at breakfast time on a Saturday, spoke with the senior carer on duty and two care staff and met all of the residents. We looked around the home and looked at records. The care of a sample of two residents was followed in this way to see if the home is providing a service that meets residents needs. Residents appear generally well. They look healthy and well looked after and can communicate comfortably with staff. What the service does well: The manager is qualified, experienced and registered with us. The staff group is stable and the home is run in the best interests of its residents. All of the current residents are men and there are some male care staff on the team so individuals can have some choice about who helps them with personal care. The home provides good personal care and makes sure that residents get routine as well as specialist health care including mental health care. There is a very low turn over of staff and they have got to know the residents well. Contact with residents families and friends is supported and staff are clearly committed to their welfare. There are good individual care plans for staff to follow that are regularly reviewed and updated. These plans weigh up the benefits and risks involved in ordinary daily events and leisure activities so that residents can live an active life in relative safety. Residents have some choice about their meals and staff do encourage healthy eating. Staff are properly recruited, supervised and trained and residents are helped to keep busy, pursue hobbies and interests, develop skills and get out and about. Residents each have their own bedroom and throughout the day use these as they please. The home is clean and tidy and smells fresh. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents receive care and support that is planned and the home does not continue to care for someone who’s needs it can no longer meet. EVIDENCE: There are currently five residents living at the home and there have been no new admissions since last inspection. We saw evidence of a planned and structured approach to moving an individual on to more appropriate care and accommodation because his needs have changed. Both care files that we looked at in our sample contained contracts/terms and conditions for care and accommodation. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9, 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Resident’s care is planned and reviewed regularly and risks are assessed and managed. Residents get the help that they need to manage their own lives as far as they are able. EVIDENCE: We looked at the care files of two residents, both are over 60 years of age. We found that each has written needs assessment that is annually reviewed by social services and comprehensive individual service user plans. These plans also show regular review. The plan for the oldest resident at the home does not sufficiently account for his age however. For example, although risk assessment is integral to each part of the plan none address the conditions and risks commonly associated with old age such as dehydration and skin viability. There is a mobility assessment. We noticed that this resident did have some difficulty getting to his feet from a sitting position at the dining table. This was made more difficult for him by staff expecting him to carry his empty plate from the table Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 10 at the same time. If the home is to continue to look after existing residents beyond their 65th birthday staff knowledge and skills about old age need to improve. Plans do contain very clear assessments and management plans for the risk of choking on food for both residents in our ‘sample’. We saw that staff help them to eat their meals following the risk plan closely. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Although the home needs to develop a more age sensitive approach to occupation and leisure for its oldest resident most residents have an appropriate and stimulating lifestyle. EVIDENCE: It was a Saturday morning and when we arrived at 9:30 some residents were up and dressed and others were still getting ready. There was a ‘Brunch’ meal cooking in oven. All residents looked alert and happy and communicated well with staff. They were also pleased to see a visitor. Files for the two residents that we looked at have a ‘student learning plan’ from City College and student reports of skills and activities learned and Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 12 practiced there through the past year. Care files also have very comprehensive and up to date activities grid records for each resident. The college was closed for the summer holidays. We looked at the activity plan for the younger of the two residents in our sample closely. We noticed that it was scored more heavily for indoor (in the house) than for outside activities in May this year. For example, ‘relaxation at home’ appeared a lot but there is no clear account of what this actually means. In July there was two activities away from the house plus college attendance. This does not seem sufficient for a whole month. A few more outside activities are recorded for August when the college is not open with ‘outing’ recorded 0n 7th, 8th and 10th August. The manager should review the amount of time that each resident spends out of the house and decide if each has sufficient community presence to meet his needs and preferences. The daily records kept are good, well written and clear. There may be too much emphasis on the 70-year-old resident having an active ‘routine’ now when he could prefer to take things easy. His plan does acknowledge that some days he does not want to get up and go out to college. The senior carer that we spoke to acknowledged that this resident doesn’t want to go to college most days. The AQAA submitted by the manager says that this resident would benefit from the home having a second lounge so he could have a quiet space in the house besides his bedroom. This should be planned and managed with his agreement. It is also an example of how the home needs to equip better to meet the changing needs of residents as they age. All residents are very heavily dependant on staff to get them food and to occupy them. They didn’t get breakfast until 11:15 on the day we were there but that may have been caused by our presence. Although it is positive to mark weekend and holiday mornings as different and more relaxed than others there was a long gap between residents last meal at 6pm the night before and their Saturday brunch. Residents were then given a snack of fruit or crisps half an hour after their brunch. The Manager says they can and do ask for tea and snacks when they like. The senior on duty the day of our visit said that early risers were offered a cup of tea. Again, older people are likely to benefit from a number of small and regular meals and drinks through a 24-hour period. The manager should review the times of meals and snacks to make sure that individuals get the quantity of food and fluid that they need when they need it to promote their mental as well as physical well being. Responding to our draft inspection report the Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 13 manager confirmed that our presence that morning did affect the timing of the meal. Pershore Road (339) DS0000016885.V337868.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Although there are some institutional practices, personal care and health care is planned and recorded. Residents are well looked after and get the support and help they need to look after themselves. EVIDENCE: Both files that we looked at contain health records including specialist and routine health care and a personal health care plan. Staff sign off risk assessment review sheets and there are monthly key worker reviews on record. All residents looked clean, well shaved, well and appropriately dressed and looked well and happy. We saw residents getting the help that they need to eat and take as much control of this as they are safely able. However we did notice that residents were sat at the dining table dressed in disposable aprons to protect their clothes for over half an hour before the food got to the table. This is an Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 15 institutional practice and there were some signs of impatience and frustration among residents. Individuals could have spent this time doing something else. Responding to our draft inspection report the manager confirmed that our presence that morning did affect the timing of the meal. We watched the administration of resident’s medication for that morning. It was carefully carried out, double staffed and checked throughout for accuracy for each resident. Residents are asked to confirm their own medicine pack from the photograph on it. This is good and enabling practice. We noticed however that staff gave the same plastic beaker to four resident to drink down their medicine without washing it. This is a hygiene hazard as the beaker passed across four people’ mouths. Infection including the common cold will spread around the house with this practice. It is also not respectful and treating people as a group is an institutional practice. The senior in charge agreed that they should use disposable cups in future. We saw PRN (only when specifically needed from time to time) guidance in the file of the older resident and a full list of medicines prescribed and a consent/agreement to administer record in both residents’ files. Pershore Road (339) DS0000016885.V337868.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Staff understand their responsibility to protect resident from harm and there are good policies and procedures. Some institutional practices erode individuality. EVIDENCE: We have heard no complaints about the home since the last inspection and no safeguarding referrals have been made. The manager has notified us of accidents and incidents concerning any resident, as she should. The manager reports that plans are well advanced to find more suitable accommodation for one resident who’s behaviour can make the others feel uncomfortable at times. This is a responsible approach. Staff that we questioned are clear about their responsibility to report any concerns about the well being of residents regardless of the circumstances. We saw staff treating all residents with respect and affection generally but there is room for improvement specifically. Referred to above we did notice staff making ‘rules’ around mealtime that we did not see accounted for in residents care plans. For example one resident was refused his cup of tea until he had got up from the table and taken his empty plate into the kitchen. He was gently ‘teased’ that someone else would get his tea if he did not comply. Residents could help to clear the table when the meal is finished Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 17 instead of getting up and down. The manager later told us that she was not aware of these rules and will look into this. If there are good, duty of care reasons for restrictions they should be agreed and written into the care plan and regularly reviewed to see if they continue to be necessary. We have referred above to other small institutional practices that can erode people’s individuality. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Although small repairs and refurbishment take too long to action the home is kept clean and is in a good location. Residents live in a comfortable home. EVIDENCE: The home is kept clean and tidy and smells fresh. A new kitchen has been installed and there is just some wall tiling to finish. The Kitchen is kept well with good hygiene procedures and residents have access to it. The exterior window frames of the house are flaking paint and some are rotting. The AQQA says that the home has a renewal and refurbishment programme and the kitchen was priority. The house is rented and the manager says that the landlord takes time to respond to requests for repairs. It is the care provider’s responsibility to ensure that residents live in a safe and comfortable home. We saw a number of small repairs that would not need the landlord’s intervention. For example there is no blind on the window Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 19 in one bathroom, and in another the toilet seat is broken off and a towel rack is broken. There is a very soiled toilet brush in a holder in one toilet and light pull cords are dirty. These, like the sharing of an unwashed beaker to take medication are infection control issues and should be kept on top of for the health of everyone in the house. There is rubbish accumulating at the foot of the garden spilling out of two sheds. This is unpleasant and could attract vermin and staff say that two residents like to use the garden frequently each day. We have referred already to the resident aged 70 who struggled to stand up from a dining chair. The manager should find out if a different type of furniture would reduce this strain. We saw residents’ bedrooms and they are kept clean and tidy with personal belongings and entertainment equipment in them. The quality of light in the lounge is poor and should be improved. This is especially important, as a number of residents including the 70 year old are unsteady on their feet and are likely to need good light to move safely around furniture. Referred to above, a second lounge type space could provide a quiet room for individuals to sit in especially the older resident. The home is in a good, high economic value location near a few local shops, on bus routes and very close to Cannon Hill Park containing the Midland Arts Centre and where many outdoor events are run through the year. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are properly recruited and are trained and supervised. An established and well-motivated team cares for residents. EVIDENCE: Two care staff plus a senior are on duty for each shift and we saw this level when we arrived on a Saturday morning unannounced. This is adequate to meet the current needs of residents. The home uses regular ‘bank’ staff to cover for holiday periods and sickness and the one that we spoke to knows the residents well. The residents look comfortable with staff and staff can communicate with them. All of the current residents are men and there are some male care staff on the team. This means that they can be offered a choice of who helps them with their personal care. The AQAA reports that no staff have left the home in the last twelve months and the senior that we spoke to confirmed this. Staff confirmed that they have regular one to one supervision sessions with a manager. The Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 21 AQAA reports that training opportunities for staff have increased and staff have made considerable progress in the completion of National Vocational Qualifications and the Learning Disability Award Framework programme with 63 of permanent and 75 of bank staff qualified to Level 2 or above. Staff spoken to are able to make some ‘common sense’ responses when questioned about the conditions, illnesses and risks generally associated with old age. We have referred already above however to the unnecessary practice of encouraging an elderly man to struggle to rise from an ordinary dining chair with both hands holding his plate so there is room for improvement. The whole staff team need to improve their knowledge so everyone knows current good practice if the home is to continue to look after their residents when they reach 65 years and their needs begin to change. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 41, 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The manager is experienced, qualified and registered with us. The home is run in the best interests of its residents EVIDENCE: The manager is experienced, qualified and registered with us and reports any incidents to us as appropriate. The annual quality assurance assessment was returned to us on time and was well filled out. Staff spoken to say that the home is well run, they are clear about their responsibilities and that residents have a good life there. The manager has a deputy and senior care assistant and the staff group is stable. We examined a sample of safety check records and found them to be in order. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 23 Referred to above there are a few hygiene/control of infection issues running through practice in the home that need to be addressed. We did see that staff wear personal protective clothing to help with personal care and other aprons when in the kitchen preparing food. Staff asked said they have an up to date food hygiene certificate and this is important as they all prepare food. The AQAA reports that the Provider Company carries out a quality assurance audit that checks various systems in the home monthly, quarterly and annually. Requirements made at the last inspection have been met but repairs and refurbishment to the home remain slow to action. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 2 29 2 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 3 LIFESTYLES Standard No Score 11 3 12 2 13 3 14 3 15 3 16 2 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 3 X X 3 3 X Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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 YA9 Good Practice Recommendations Expand the mobility risk assessments for residents to guide staff in best practice for individual needs. Practices that increase physical strain should be identified and avoided as necessary. Audit the proportion of time that individuals spend on active involvement against the time that they spend doing nothing purposeful and use the information to improve their social and leisure life. Monitor the actual length of gaps between meals, especially over night. Use this information to make sure that each individual gets the appropriate quantity of food and drink for his particular needs when he needs it. This will contribute to mental as well as physical well being particularly for older residents. Provide a clean cup for each individual to take his medication so that infections are not spread orally through the home. If there are therapeutic reasons for the way in which meals DS0000016885.V337868.R01.S.doc Version 5.2 Page 26 2 YA12 3 YA17 4 5 YA20 YA22 Pershore Road (339) 6 7 8 9 10 YA27 YA28 YA29 YA30 YA35 are conducted, they should be justified in writing in individuals care plans so they are agreed and transparent. Keeps blinds on bathroom windows and replace broken fixtures in a timely way so that residents can use a private bathroom with dignity. Formulate plans for another sitting room/space on the ground floor so that residents can withdraw from each other without isolating themselves in their bedroom. Provide furniture that will help individuals who have lost agility. Review the hygiene and control of infection policy and procedures for the home so that practices keep residents safe from avoidable infection. Arrange training for the whole staff team on the conditions, illnesses and risks commonly associated with old age. This is so the care and support of older residents can be appropriately planned and carried out and changing needs accommodated in the future. Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45 – 46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Pershore Road (339) DS0000016885.V337868.R01.S.doc Version 5.2 Page 28 - 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!