CARE HOMES FOR OLDER PEOPLE
Phoenix House 54 Andrews Lane Formby Liverpool Merseyside L37 2EW Lead Inspector
Mrs Trish Thomas Key Unannounced Inspection 11:00 24th November 2006 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 Phoenix House DS0000064015.V295392.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. Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Phoenix House Address 54 Andrews Lane Formby Liverpool Merseyside L37 2EW 01704 831866 01704 831866 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) Total Care Homes Ltd Sandra Farrell Care Home 18 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (16), of places Sensory impairment (1) Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Service users to include 18 OP The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 25th July 2006 Date of last inspection Brief Description of the Service: Phoenix House is a care home for 18 older people situated in a quiet residential street in Formby, close to a bus route and train station. The home is a converted Victorian villa with a car park at the front of the building and secluded gardens at the back. There is a large communal lounge, a separate dining room, and bedrooms are situated on ground and upper floors. The home has an assisted bath, but does not have a hoist. Phoenix House is staffed throughout the day and night, providing personal care, home cooked meals and a laundry service. All residents are registered with a G.P. of their choice and are supported in accessing district nursing and paramedical services, as needed. The registered provider of Phoenix House is Dr. Chris Farrar, Total Care Homes Limited, and the registered manager is Mrs. Sandra Farrell. Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an un-announced visit and the methods used were discussing the service with residents, visitors and staff, checking requirements from the last inspection and touring the premises. A number of records compiled in the home as to care practice, health & safety and staffing were read. What the service does well: What has improved since the last inspection? Risk assessments have been carried out for resident(s) who smoke in their bedrooms. One such resident was spoken with and was aware of the risks posed by this. An ashtray was in reach and the room was well ventilated. The risk assessment was read and was satisfactory. The manager said that recording formats for pressure care, including fluid balance charts, diet and weight monitoring charts have been established. These were not in use at the time of this visit. The manager said that none of the residents required that level of care input.
Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 6 Records are now maintained of activities and outings on offer for residents and their participation. Residents, who had previously expressed dissatisfaction with activities on offer, expressed no concerns during this visit. Similarly, a resident who had previously expressed concerns about meals said that she/he is served whatever she/he asks for and was satisfied with that arrangement. Staff confirmed that residents are consulted about their meals and the majority of residents said the food was good and there are alternatives to the main menu. In response to an incident observed during the last inspection, the manager said that she has spoken to a member of staff regarding her conduct towards a resident, and was confident that the incident would not be repeated. Residents expressed no complaints about staff conduct during this visit and nothing (relating to residents’ treatment) was observed that would give cause for concern. What they could do better:
To ensure that the service and facilities can meet the needs of residents accepted into the home, the registered person must ensure that only those whose needs are within the registered category are admitted. The home must apply to CSCI for variations for any residents who have had professional assessments of confusion/dementia prior to admission. The home should be able to demonstrate that staff skills and numbers, the environment and facilities on offer can meet each resident’s needs. To ensure the safe management of medication, improvements to systems must be established. The regulation refers to the safe recording of medication and where it is necessary for staff to write the drug and dose on residents’ Medication Administration Sheets, the writer must sign the entry and have a colleague check and sign to avoid mistakes in administration. The regulation refers to safe administration of medication. For PRN/As required medication, individual care plans must be formulated to ensure that staff are clear as to when these are to be administered and the reasons. For residents who selfmedicate, risk assessments must be carried out and reviewed to ensure they have capacity to manage medication. To ensure residents’ privacy and dignity is respected, the registered person must provide a private communal telephone for residents.
Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 7 To ensure that residents’ food is edible and to their satisfaction, the registered person must ensure that food served in their bedrooms is covered when transported to ensure it is hot when served. To ensure that residents are protected from abuse and staff are aware of the indicators of abuse, the registered person must arrange for staff to be trained in the protection of vulnerable adults. To prevent infection, toxic conditions and the spread of infection in the care home, the registered person must arrange for the ground floor toilets to be maintained to the highest standards of hygiene and provide antibacterial hand wash in these areas. An extractor fan will be necessary in one toilet to avoid odours from the bathroom entering a nearby bedroom. To protect residents in case of illness or accident and to ensure staff have the necessary skills, the registered person must provide first aid training for staff who work in the home. To protect residents and eliminate risks to their safety, the registered person must arrange for a cover to be fitted on the radiator (under the window in the lounge). Four residents said they were not satisfied with access to toilets on the ground floor, and o ensure that they have access to toilets as needed, the registered person should review provision of toilet facilities on the ground floor and assist residents to make use of upper floor toilets if needed. In respect for residents’ autonomy and choice and in response to feedback received during the visit, recommendations are made that the television controls be left within their reach and they are provided with keys to their bedrooms in accordance with preference and assessment. 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. Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 8 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 Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Quality in this outcome area is adequate. Pre admission assessments are carried out before residents are admitted to the home. The home has accepted a resident whose assessed needs are outside the registered category. This judgement has been made using available evidence including a visit to this service. Phoenix House does not provide intermediate care and was not assessed against standard 6. EVIDENCE: The care records of three residents were seen. The home has an assessment format and staff carry out an assessment of the prospective residents’ needs before they are accepted into the home. For more recently admitted residents, the newly established single assessment forms had been completed prior to
Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 10 admission by their social worker. The assessments cover the range of physical health, mobility personal care and mental health needs necessary on admission to residential care homes. One resident’s needs were described as “Confused and unable to converse for this assessment.” It is further recorded that it was not possible to ascertain if the person truly understood his/her situation. Phoenix House is not registered to admit residents assessed with confusion/dementia. Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 and 10. Quality in this outcome area is adequate. All residents have care plans and have access to health services. Improvements will be necessary to management of residents’ medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were seen and there were action plans on record to meet the individual’s assessed needs. Care plans follow a standard format and information was easily accessed. Care plans which were read, had been reviewed and adjusted to meet changes in dependency. The manager, Mrs. Farrell said that there are formats established to monitor pressure care and
Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 12 record fluid intake and that there were no residents in need of this level of support at the time of the visit. Care plans contained risk assessments for mobility and general safety. Examples seen were assessments regarding using the stairs, leaving the building without an escort and smoking. All residents who made comment said that they are registered with a G.P. and that there are arrangements for them to have chiropody treatment and attend hospital appointments if necessary. Some residents had retained their usual G.P. on admission to the home. For others who had previously lived out of the area, alternative arrangements had been made with local doctors. Reference was made to residents’ care files. Care plans record referrals to health services in response to any deterioration in general health and there are standardised formats in place for recording medical interventions. The home has a procedure for managing residents’ medication. For the residents whose care was tracked, there were adequate stocks of their medication and this was held secure. The majority of medication records had been printed by the pharmacy and were satisfactorily maintained. In instances where it is necessary for staff to write in the drug, dose and time to be given, on a resident’s MAR sheet, the writer must sign the entries and have a colleague check these against the pharmacy containers and also sign as correct. For PRN/As required medication, (examples observed : paracetamol, lactulose, immodium) individual care plans must be formulated detailing when these are to be administered and the reasons. One resident said she/he had not received her/his inhaler from staff after lunch. The manager said the resident had left the room before staff had a chance to give this to her/him. There must be checks in place, in response to residents’ presenting behaviour, to ensure that they receive their medication at the times specified. Other than when a resident refuses or is incapacitated, staff have responsibility to administer their prescribed medication. For those residents who are self-medicating, there were no risk assessments in evidence. Residents must be assessed as capable to self-medicate and secure their medication and records must be maintained. Residents looked well cared for, some appeared unsettled and expressed some concerns during this visit. One resident said that the controls for the television had been taken out of the lounge by staff, which was limiting choice. Another resident said, “I feel as if we’re being let down. Lack of cleanliness perturbs me.” Residents were aware that there are proposals for alterations to the building. One resident was concerned that the outlook to the back garden may change. Residents made no complaints about staff conduct or their present accommodation. One resident who moved in recently, said that the staff are very helpful and pleasant and he/she has no complaints.
Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 13 Residents have single bedrooms and some have en-suites. Some of the residents prefer to remain in their bedrooms for part of the day and have their meals in the dining room. Two were spoken with in their bedrooms and both had no complaints. One resident said the en-suite is convenient and her room is comfortable and to her liking. Another said the room is comfortable but the small flight stairs to the landing may become difficult to manage in the future, otherwise there were no concerns. This resident said the meals and support provided in the home were very good and the staff are pleasant and helpful. A visitor said, “My mother is doing very well here. Everything is fine. Myself or one of the family come in most days and we have had no cause for concern.” A resident was observed in the dining room using the phone which had been passed through the hatch from the kitchen, there was a lack of privacy as staff, a visitor and other residents were within hearing. In response to a resident’s concerns about the security of her property, it is advised that the position regarding provision of room keys for residents is reviewed in accordance with individual risk assessments. Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15. Quality in this outcome area is adequate. As far as it is possible to ascertain, the lifestyle experienced in the home matches residents’ expectations and preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager produced records of activities on offer and confirmed that residents are consulted about what they would like to do. The manager said that two residents went on a recent outing, the remainder preferring to remain at home. Although they had done so on previous visits, residents expressed no concerns about the frequency of social activities and outings. Some of the residents were in their bedrooms during the visit and they appeared relaxed and at ease. A number were in the main lounge watching television and some were in the dining room enjoying a board game. Two visitors were spoken with (one a relative and one a friend of residents) and residents said they have regular visitors. Residents’ religious affiliations
Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 15 are recorded on their care plans and those who commented were satisfied with support and respect for their beliefs and preferences. Residents were spending time as they chose in their lounge, dining room and in their bedrooms. One resident said, “I stay in my bedroom a lot of the time, and eat in the dining room. It is all new to me but I have friends here and the food is great. I have a word with people as I see them.” Another resident said, “I come and go as I please, I get out to the shops and prefer to stay in my bedroom rather than sit in the lounge.” Residents in the lounge said that staff had taken away the television controls. The remote control was seen on the table in the hallway. A number of residents have televisions in their bedrooms. Where there are a group of residents using a lounge, it is difficult to cater to everyone’s preference of television programme. However, residents should be able to discuss and control what programmes to watch. The manager said that the cook had left the home and a replacement cook is in post. Two members of staff were spoken with and they said that residents are shown the menu, asked what they would like to eat and offered alternatives if necessary. The manager confirmed that resident diet and weight monitoring formats have been established. There were adequate food stocks in store with a choice of cereals and hot and cold drinks in evidence. A resident who had been critical of the food on offer during the last visit said she/he has no complaints now, she/he is given whatever she/he asks for and is satisfied. Others said the food was fine, another said she thought the portions may have been getting smaller but she had not experienced any hunger or adverse effects. Some residents have their meals served in their bedrooms. One resident said there were no complaints about the food but said it was often cold by the time it arrived. Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is adequate. The home has procedures for dealing with complaints and protecting residents from abuse. Training for staff in, protection of vulnerable adults, is required. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been one complaint to CSCI regarding access to the building, which was referred to the registered provider, Dr. Farrar. He responded to the complainant within the required timescales, in accordance with the home’s complaints procedure. The home has procedures for protection of vulnerable adults and “whistleblowing.” A number of staff have not received training in protection of vulnerable adults and this is a requirement of this report. Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 21,26. Quality in this outcome area is adequate. The building is generally well maintained with suitable access for ambulant residents or by use of a mobile ramp. Toilet facilities on the ground floor do not appear to be meeting residents’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The building is homely and generally well-maintained. The lounge and dining room are pleasant and domestic in style. Residents’ bedrooms are highly personalised and vary in size and aspect. There are stairs on the upper landing, which restrict use of some upper rooms as only suitable for ambulant
Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 18 residents. The home has a mobile ramp to assist access to the front of the building, where there are two shallow steps. There is also a step in the hallway. Residents expressed satisfaction with their bedrooms and the communal areas, saying they were “pleasant”, “as I like it,” and “comfortable”. Due to change in demand for toilets in accordance with residents’ needs, some were not satisfied with toilet facilities on the ground floor. One resident said about twelve people use the toilet near her bedroom during the day. Another resident said the toilet is sometimes soiled and she has not seen antibacterial hand-wash for staff and residents to use. She said she is used to high standards and feels let down by the recent deterioration in the cleanliness of the toilets. One resident said the odours from an adjacent toilet are evident in her bedroom, she said that she has requested that an extractor be placed in the toilet, but this has not been done. She said conditions in her bedroom are often unpleasant due to this situation. Both ground floor toilets were clean during the inspection and were in demand by residents, particularly after lunch. Residents were waiting in the hallway and lounge to use the toilet. Remaining areas of the building, including the bedrooms, communal areas, kitchen, laundry and food stores were clean and well managed. Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29,30. Quality in this outcome area is adequate. Management and staffing in the home were satisfactory but further training will be necessary. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Reference was made to the staff rosters, which were satisfactorily maintained. There has been a fairly high turnover of staff in recent months and both members of staff on the afternoon shift said they were had given notice. A senior care assistant and a cook have also left recently. The home employs domestic, cooking staff and an administrator in addition to care assistants and the registered manager. On duty at the time of visit was Mrs. Sandra Farrell, (manager), three care assistants, one domestic and a cook, for eighteen residents. The manager confirmed that new staff have been recruited recently to cover vacancies. The manager confirmed that over 50 percent of staff have NVQ. She described recent problems with a training agency resulting in certificates not having been issued in some cases. She said the matter was under investigation. The
Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 20 manager said staff who administer medication have received certified training but first aid training was out of date. Staff files for two staff were read and were well maintained with satisfactory references, clearances, identification and contracts of employment in evidence. Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,38 Quality in this outcome area is good. The home is well managed and has systems in place to protect residents’ best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager, Mrs. Farrell is registered with CSCI, has many years experience working in the home as a senior, and has been in post as manager for several months. She is undertaking a management course.
Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 22 The home has a quality assurance system carried out by a firm of consultants. The last annual audit was completed in June 06 and the process included residents’ opinions of the service. The records of outcomes were read and were satisfactory. The manager confirmed that the home does not become involved in residents’ personal financial affairs. None of the residents who commented expressed concerns about their personal finances. A resident said, “They don’t interfere, I manage my own money and get by perfectly well.” Another said, “A relative sees to all that for me and that’s the way I want it.” Health & Safety certificates were seen and were in date. The fire book was satisfactorily maintained. On a tour of the building, the surface temperature of the radiator under the window in the lounge was extremely hot. It is required that a cover be fitted to protect residents from burns. Phoenix House DS0000064015.V295392.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 Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14 (d) Requirement Reg. 14 (d). “The registered person has confirmed in writing to the service users that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare.” Timescale for action 25/11/06 2. OP3 14 (d) 3. OP9 13 (2) The registered person must admit only those whose assessed needs are within the registered category of the home ongoing from the given date. The registered person must 07/01/07 apply to CSCI for variation(s) for any resident (s) whose needs are not within the home’s registered category. 07/01/07 Reg. 13 (d). “The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home.” The registered person must formulate individual care plans for PRN/As required medication and in response to residents’ Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 25 behaviour patterns when medication is being administered. 4. OP9 13(2) The registered person must ensure that handwritten Medication Administration Records are signed by the writer and checked and signed by a colleague. The registered person must ensure that risk assessments are carried out regarding residents’ self-management of medication. Reg.16 (2) (b). “The registered person shall having regard to the size of the care home and the number and needs of service users : provide telephone facilities which are suitable for the needs of service users, and make arrangements to enable service users to use such facilities in private.” The registered person must provide a private communal telephone for residents. 7. OP15 16 (2) (i) Reg. 16 (2) (i)“The registered 25/01/07 person shall provide, in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared and available at such time as may reasonably be required by service users.” The registered person must ensure that food served in residents’ bedrooms is covered when transported to ensure it is hot when served. Reg.16(6). “The registered person shall make arrangements by training staff or by other measures, to prevent service users being harmed or suffering
DS0000064015.V295392.R01.S.doc 07/01/07 5. OP9 13(2) 07/01/07 6. OP10 16 (2) (b) 25/01/07 8. OP18 13 (6) 25/03/07 Phoenix House Version 5.2 Page 26 abuse or being placed at risk of harm or abuse.” The registered person must arrange for staff to be trained in the protection of vulnerable adults. 9. OP26 13 (3) Reg. 13 (3). “The registered person shall make arrangements to prevent infection, toxic conditions and the spread of infection in the care home.” The registered person must arrange for the ground floor toilets to be maintained to the highest standards of hygiene. The registered person must arrange for an extractor fan to be fitted in the ground floor(extension) toilet. Reg. 18 (1) (c)”Ensure that persons employed by the registered person to work at the care plan receive – (i) training appropriate to the work they are to perform.” The registered person must provide first aid training for staff who work in the home. Reg. 13 (4) (a). “The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety.” The registered person must arrange for a cover to be fitted on the radiator (under the window in the lounge). 07/01/07 10. OP26 13 (3) 25/01/07 11. OP30 18 (1) (c) 25/02/07 12. OP38 13 (4) (a) 25/02/07 Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 27 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 OP14 OP10 OP21 Good Practice Recommendations The registered person should ensure that the television controls are kept in the lounge for residents’ use. The registered person should provide bedroom keys for residents following consultation and individual risk assessments. The registered person should review provision of toilet facilities on the ground floor and assist residents to make use of upper floor toilets if needed. The registered person should provide antibacterial handwash in toilets. OP26 Phoenix House DS0000064015.V295392.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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
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