CARE HOMES FOR OLDER PEOPLE
Pinewood Lodge Oxhey Drive Watford Hertfordshire WD19 7HR Lead Inspector
Mr Tom Cooper Unannounced Inspection 23rd January 2006 2:15 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 Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 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. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Pinewood Lodge Address Oxhey Drive Watford Hertfordshire WD19 7HR 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) 0208 421 7900 0208 421 7961 Quantum Care Limited Ms Elizabeth Grace Street Care Home 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60), of places Physical disability over 65 years of age (60) Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th July 2005 Brief Description of the Service: Pinewood Lodge is a modern, purpose built home that was completed in 1997. It comprises a two-storey building with a main entrance to the first floor at upper ground level and a lower ground floor. Accommodation is offered in four 15 bed units, catering for a maximum of 60 older people requiring long term residential care. All bedrooms are in excess of 12 sq. metres in area and have en-suite toilets and sinks. Each unit has a separate lounge and dining area, a fully fitted kitchenette and a medication storage station. Other facilities available to service users include a ground floor conservatory and first floor hairdressing salon. Each unit has a communal assisted bathroom and assisted shower room. The home has a fully fitted stainless steel equipped kitchen with appropriate storage rooms and cold storage equipment and a well-equipped laundry facility. The gardens extend around the home, which is screened from the road and neighbouring buildings by mature hedges and trees. There are pleasant patio areas where residents can sit out. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second unannounced inspection for the year 2005/6 under the National Minimum Standards for Care Homes for Older People and the Care Homes Regulations 2001. The last inspection was carried out on 7th July 2005. The inspection took place over one afternoon/evening on a weekday. Discussions were held with service users, three visiting relatives and members of staff on duty including the manager, deputy manager and care assistants. Documentation examined included samples of service users’ care plans, staff recruitment and training records, complaints records and medication, fire drill, accident and incident records. Staff were observed working with service users and three units were visited, including a number of residents’ bedrooms and bathrooms. What the service does well:
The home has detailed documentation on the nature and level of service promised that is available to prospective and current service users and their representatives. Admissions to the home are made on the basis of full assessments of need carried out in advance. Following admission, service users’ personal and healthcare care needs are documented and reviewed regularly in care plans made out in the standard Quantum Care format, involving the individual concerned and other significant people. Service users were well presented physically, with tidy hair and fingernails and wearing appropriate, reasonably clean clothing. Those who were able to express opinions said that they were generally satisfied with the service provided, praising the attitudes and performance of staff, the food provided and the accommodation. Staff treat service users with respect and seek to promote their privacy and dignity. Residents expressed satisfaction with their lifestyles and staff facilitate a number of activities for them designed to provide stimulation and recreation however this aspect of care needs to be improved. A good standard of nutritious and well balanced food is supplied that most residents enjoy. The home has a robust complaints procedure that is well publicised to residents and their representatives and the home has documentation indicating an effective response to complaints raised. Good systems are in place for the protection of service users, including careful staff recruitment procedures and training in abuse prevention and adult protection.
Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 6 Visiting relatives spoken with expressed mixed views about the quality of care at the home, one describing it as was excellent and two others raising some concerns about healthcare practice. However all said that staff were caring and friendly. A full premises inspection was not conducted, however all areas seen were clean and tidy and free from unpleasant smells. The unitised building with smallish living areas, wide corridors and pleasant grounds, provides a comfortable environment suitable for elderly people with restricted mobility and suffering from varying degrees of dementia. Staffing arrangements by day and night remain satisfactory. The new manager, not yet registered, is experienced and well qualified to run the home supported by a relatively new senior team. She had been in post for one month and had already identified areas for improvement and change, especially in respect of care planning, activities provision and record keeping. Staff spoken with said that they felt well supported, although the two changes of manager in recent months had inevitably been somewhat unsettling. What has improved since the last inspection? What they could do better:
Most care records seen were adequate, however failures were noted in respect of the recording of the physical care of one resident with a pressure sore and weight loss. Accurate records of the delivery of the actions agreed to meet individual needs must be made in every case. Also, monthly review notes made by staff in care plans should be more detailed and more information and tips on specific care tactics found to be helpful should be included.
Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 7 An activities coordinator should be recruited and the range and scope of activities offered in the home expanded to provide service users with more stimulation and choice. Wheelchairs with defective brakes must not be used. The soiled armchair covers in the lounge of Oxhey unit should be cleaned or replaced. Although staff said they felt well supported, the frequency of individual staff supervision should be increased to at least six sessions per annum to meet the standard. Mandatory staff training should also be kept up to date as records showed that this was overdue for a number of staff. 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. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 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 Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 5 Information is available to enable prospective service users and their relatives/advocates to determine whether the home would suit them. The home’s assessment and admission process adequately ensures that prospective service users’ needs could be met by the home. Prospective service users and their relatives and friends have good opportunities to assess the care principles and facilities of the home prior to admission. EVIDENCE: It has previously been established that the home has a statement of purpose and a service user’s guide that contain the information required to meet the standard. The manager stated that residents had been given a copy of the service user’s guide. Service users’ care plan files examined included details of pre-admission assessments undertaken by a senior member of staff. Service users and staff
Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 10 consulted said that prospective service users and their relatives/friends generally visited the home prior to admission. They would spend time looking around, speaking to other service users and would be offered a meal. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Service user care plans are in place detailing individual health, personal and social care needs and are regularly updated. Service users and relatives are involved in care planning. However more details should be included on monthly update sheets and more helpful hints and suggestions should be noted on how to approach individuals to deliver care in the way they require. Staff monitor service users’ health and well being and record individual progress. However care must be taken to follow the care plan actions stipulated and accurate records of care delivery must be made by staff. The home has sound medication policies and procedures that should protect service users. Service users feel secure in the home and feel that staff treat them with respect and promote their privacy. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 12 EVIDENCE: Service users consulted said they were happy with the approach and performance of staff and this made them feel secure and well cared for. Care plans sampled contained good details of individual needs and the actions to be taken to meet them, including references to any cultural or spiritual needs. However they were rather basic documents and would benefit from expansion to give more information about the service users as persons, for example by including tips on how best to approach individuals to achieve the best outcome. With one exception the care plans seen contained consistent recording of the care given and progress of the service users. However many undated documents were found. In one case the recording of the treatment of a pressure sore was poor, with records of staff failing to follow the district nurse’s turning instructions correctly and no details recorded at all of the treatment given by staff after a certain date. Other inconsistent recording was also noted in the care plan. A visiting relative of this service user expressed dissatisfaction over his healthcare. Staff must always follow the actions prescribed by health professionals and accurate records of all healthcare intervention and treatment must be kept. It was also noted that a number of female service users had sore looking skin on their lower legs. Staff should pay more attention to skincare and the manager should consider obtaining specific training for staff in this vital area of care practice. Monthly reviews of care plans had been carried out, which was positive, but the update notes were somewhat lacking in detail and should be expanded to give a better overview of individual status and progress. It was also positive to note that many staff had attended care planning training. See requirements and recommendations. Medication storage and administration records were checked in two units. The home uses the Nomad daily dosage system of pills supplied weekly in plastic containers. Medication is stored on each unit in locked cabinets. Sound procedures are operated that should protect service users. Accurate records of items coming into the home and administered to service users were found with only one signature gap noted on the medication administration record (MAR) sheets. This had been noted and dealt with by staff during monitoring of the records. Only trained staff may administer medication. The home has appropriate policies and procedures covering maintaining dignity and respect for service users. Observation of staff at work and feedback from service users and three visitors demonstrated that residents were generally treated respectfully. Service users said that staff always knocked and waited at their bedroom doors before entering and this was observed in practice. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 & 15 Service users’ interests, expectations and aspirations are considered and identified by staff and are currently fulfilled to some extent. The home has a programme of social and recreational activities available for service users but this is not being consistently delivered without a designated activities coordinator in post. Links with the local community are good and service users are able to maintain social contacts with families and friends as they wish. Service users receive a wholesome and balanced diet with a reasonable amount of choice of food available. EVIDENCE: As reported in the last inspection report, the activities coordinator’s post remains vacant despite attempts to recruit to it. However the manager stated that three candidates were due for interview in the week after the inspection and she was optimistic that one would prove suitable for appointment. Given the large number of residents with confusion or dementia the activities coordinator would be crucial to oversee the delivery of a full programme of activities. Even so, the new manager was of the view that staff must provide
Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 14 adequate opportunities for stimulation on each shift and had issued instructions to that effect. Some details of regular organised events such as tea dances and hand massage sessions were advertised in each unit. All the residents who expressed opinions either said they were happy with the lifestyle on offer or had no interest in activities. Although the standard is not fully met, no requirement has been made in view of the efforts being made by the organization to expand the service provided in this key area. Staff support service users to maintain contact with family and friends. Service users can receive visitors in private and there are no strict visiting times. There were many visitors in the home during the inspection and those spoken with commented that they were always made to fell welcome. All the service users asked said that the food provided was of good quality, well presented and reasonably varied. They confirmed that alternative meals were available, meaning there was always a choice. Individual food preferences and dietary requirements were noted on care plans seen and catered for appropriately. Most residents take their meals together in the dining rooms and staff help individuals as necessary in a gentle and sensitive way so that sufficient nutrition is taken. A relaxed, social atmosphere was noted at dinner in the unit observed. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Information on how to make a complaint is available and service users and their relatives feel confident that any complaint they make will be listened to and acted upon by the manager. Complaints records show that matters raised are dealt with speedily and satisfactorily. Adult protection policies and procedures are in place that should ensure the safety of service users. EVIDENCE: Quantum Care has an adequate complaints procedure and information on how to make a complaint is available to service users, relatives and involved professionals in the service user’s guide and elsewhere. Staff spoken with had a good understanding of the principles involved in dealing with a complaint. Many of the residents had dementia and were unable to comment however those who did said they knew who to approach if unhappy about any aspect of life in the home. Relatives spoken with were aware of the complaints procedure. Two formal complaints had been received by the home since the last inspection. These were ongoing and documentation was available to demonstrate that the company’s procedure was being correctly followed. The manager was aware of the need to learn any lessons from complaints raised and to take action if necessary to change practices in the home to improve the quality of the service. The company has a whistle blowing policy that is available to staff. Individual staff spoken with were aware of this policy and had a fair grasp of their
Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 16 responsibilities under it. There are also policies on adult protection and evidence was presented of recent anti-abuse training given to most care staff. The topic is covered in the induction programme for staff and also forms part of the NVQ2 course undertaken by many staff. Therefore the standard is now met. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The building and grounds provide a safe, well maintained and comfortable environment for the service users. The four unit lay-out of the home produces smallish domestic living areas that are homely and suit the needs of people with restricted mobility and confusion. A high standard of cleanliness was evident enabling service users to enjoy pleasant and hygienic living spaces. EVIDENCE: Pinewood Lodge is a modern design, purpose–built in 1997 with wide corridors, large bedrooms (over 12 square metres) and spacious communal areas. Grabrails, assisted bathing facilities, hoists and pressure care equipment are provided to meet the needs of service users and ensure maximum accessibility and independence. There is a programme of routine maintenance in place and a fair standard of decoration throughout the building. The manager explained that all the units were due for redecoration in more subtle colour schemes
Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 18 more suited to the orientation of people with confusion and dementia. This will be a considerable improvement, although the premises are already maintained to a satisfactory standard. The fabric covers on the armchairs in the lounge of Oxhey unit were noticeably soiled and these should be cleaned or replaced to maintain a dignified setting. All areas seen were clean, with an excellent standard of housekeeping and no unpleasant smells noted despite the high number of incontinent service users in the home. Staff have access to supplies of plastic gloves and aprons as needed. Domestic and clinical waste and soiled laundry are managed safely in accordance with proper infection control procedures. Staff are aware of the relevant risks (evidence was seen of reasonably recent infection control training) and act accordingly. No health hazards were noted apart from one wheelchair in use that had a broken brake. This must be removed from service and repaired. See standard 38 and requirements. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 & 30 Staffing levels are adequate to meet service users’ needs and fulfil the aims of the home. The home has rigorous recruitment and staff selection policies and procedures that protect the interests of service users. The home’s induction, supervision and ongoing training policies ensure that staff are adequately trained and competent to do their jobs. However staff training in mandatory disciplines needs to be kept up to date. EVIDENCE: The manager stated that there were normally three staff on duty in each of the four units during the day shifts. Staff spoken with confirmed that this was generally the case but not always and when numbers were reduced it made the work very hard. Night staffing is by a minimum of four care staff awake including a senior care assistant. Staff rotas were available to support this. The manager and deputy’s hours are supernumerary and are excluded from the staffing calculation. Use of agency staff is not excessive however the manager has identified a clear need for recruiting more permanent staff to aid the consistency of care. She has also informed the agency supplying staff that she expects a higher standard of performance from them. This is a commendable attempt to improve standards.
Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 20 Although this was not specifically inspected on this occasion, a number of staff have completed the NVQ2 course and more are due to start. Quantum Care has rigorous policies for the recruitment and selection of staff and these are followed by the home. Staff files examined contained the required identity and reference information to meet the standard. New recruits receive a structured induction programme so that they understand the aims of the home and gain a working knowledge of the company’s policies and procedures. Evidence was seen that many staff had attended care planning and adult protection training, although mandatory training in areas such as fire safety, food hygiene, moving and handling, first aid and infection control was in need of updating for some staff. The observations of staff working with residents and the general standard of care plan documentation seen indicated that staff were competent to care for the service users, although as reported earlier there were concerns about the delivery of pressure care for one service user in one unit. Recommendations have been made in respect of mandatory training updates and record keeping practice. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36, 37 & 38 The manager is experienced and well qualified to manage the home and provides strong leadership consistent with the ethos of the home. Staff feel adequately supervised and supported by more senior staff to ensure that the aims of the home are met. However the frequency of formal one to one supervision should be increased. All records required by regulation are maintained satisfactorily, with the exception of the healthcare records of one service user. Staff must follow health care instructions from involved health professionals and make accurate records of the delivery of care as instructed. The home has a health and safety policy and in general safe work practices are followed to ensure the establishment is a safe place to live in. However one wheelchair was in use with a defective brake and this must be removed from service until repaired. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 22 EVIDENCE: The new manager had been in post for a month. She has a management qualification (CMS) and is taking the NVQ4 course. She has considerable relevant experience in social care, having worked in several other Quantum Care homes. She had already introduced several initiatives in the home and expressed a clear commitment to raise standards in the home, especially in care management and activities. She had forged a good working relationship with the deputy manager. Staff spoken with rated teamwork and communications in the home as mostly good and praised the open approach of the senior team. They also said they felt well supported, although the frequency of individual supervision sessions remained patchy due to the shortage of senior staff on some units. Therefore the recommendation made at the last inspection regarding supervision has been restated. The standard requires six one to one sessions per annum for each member of care staff. Most records examined were adequately maintained, such as care plans, the medication and fire drill records. However the failure reported above regarding the recording of the treatment of a service user with a pressure sore means that this standard was not met. A full premises inspection was not carried out on this occasion. However the building appeared safe for service users and staff. The home has a health and safety policy in place and promotes safe working practices. The only health and safety problem noted was a defective wheelchair, as reported above. Mandatory training for staff needs updating. Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 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 3 X 3 X 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 2 2 2 Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 24 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. 1. Standard OP8 Regulation 12, 17 Sch 3 Requirement Timescale for action 23/01/06 2. 3. OP38 OP38 The registered person must ensure that service users receive proper treatment for their health and welfare. Accurate records of the delivery of the actions taken to treat pressure sores must be made in every case. 13 (4)(c)& Wheelchairs with defective 13(5) brakes must not be used. 13 & Mandatory training for staff in 18(1)(c) first aid, moving and handling, (i) infection control, food hygiene and fire safety must be kept up to date. 23/01/06 31/03/06 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. Refer to Standard OP7 OP7 Good Practice Recommendations Monthly review notes should be in greater detail, in order to reasonably reflect the changing needs and requirements of each service user. (previous recommendation) Care plans should contain more information and tips on
DS0000019496.V267482.R01.S.doc Version 5.0 Page 25 Pinewood Lodge 3. 4. 5. OP8 OP12 OP36 helpful care tactics for staff to follow. All documents should be dated to indicate their relevance and aid monitoring. Skin care training should be provided for staff. An activities coordinator should be recruited and the range and scope of activities offered in the home expanded to provide service users with more stimulation and choice. The frequency of staff formal supervision should be increased to once every 2 months, at minimum. (previous recommendation) Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Pinewood Lodge DS0000019496.V267482.R01.S.doc Version 5.0 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!
