CARE HOMES FOR OLDER PEOPLE
Read House 23 The Esplanade Frinton On Sea Essex CO13 9AU Lead Inspector
Marion Angold Unannounced 3 August 2005
rd 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 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. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Read House Address 23 The Esplanade Frinton On Sea Essex CO13 9AU 01255 673654 01255 673177 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Essex Volutary Association for the Blind Mrs Rosemary Danby Care Home 40 Category(ies) of Sensory Impairment over 65 years of age (40), registration, with number Old age, not falling within any other category of places (40) Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Persons of either sex, aged 65 years and over, who require care by reason of Old Age (not to exceed 40 persons). 2. Persons of either sex, aged 65 years and over, who require care by reason of a physical disability (not to exceed 40 persons). 3. Persons of either sex, aged 65 years and over, who require care by reason of a sensory impairment (not to exceed 40 persons). 4. Persons of either sex, aged 65 years and over, who require care by reason of dementia, whose names were provided to the Comission in May 2005. 5. The total number of service users accommodated in the home must not exceed 40 persons. Date of last inspection 4th March 2005 Brief Description of the Service: Read House is a purpose built establishment for older people with sight impediments and is owned by Essex Voluntary Association for the Blind. The home offers accommodation on three levels, with all rooms being serviced by a passenger lift. All rooms are now for single occupancy, with en-suites, and two are designated for respite care. Attached to Read House is a day centre. Service users are encouraged to participate in its activities on a weekly basis and attend special events, such as concerts. The home is situated on the promenade of Frinton-on-Sea, within easy reach of the town. Read House provides a number of facilities for older people with sight impediments. This includes a sensory garden to the rear of the premises. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection involved two inspectors, the Lead Inspector, Marion Angold, was assisted by Andrea Carter, Inspector. The inspection took place on one day between 10.20 and 16.40 hours. The Registered Manager, Rosemary Danby, was on leave, and it was Janet Plant’s (newly appointed Responsible Individual) day off. The home’s training officer was in charge of the home in their absence and ably supported the inspectors throughout the day, although her access to records was restricted. Most of the inspectors’ time was spent observing what was taking place in the home and speaking with service users and staff on the two upper floors. A sample of care plans, supervision, training and medication administration records were also inspected. The inspectors subsequently met with the Registered Manager and Responsible Individual, at their request, to clarify some of the issues raised by the inspection. Of the 15 National Minimum Standards inspected, 10 were met and 5 were found to involve minor shortfalls. Some of the previously unmet Standards were not inspected on this occasion and therefore re-appear in the table of requirements and recommendations at the end of this report. What the service does well:
Suitable arrangements and staff training had been provided for meeting residents’ heath care needs and ensuring that they received their medication. The GP, serving the home, held a weekly surgery on the premises. Residents had opportunity to use the day centre once a week and attend occasional concerts on the premises. More able residents were supported to maintain interests, such as gardening, and some enjoyed the weekly programme of activities and any opportunity to go on an outing in the minibus. The home employed a team of kitchen staff for all aspects of meal preparation. They catered for particular dietary needs as well as offering menu alternatives. Comments from staff and residents were positive, particularly from a person, who needed a special diet. It was also encouraging to hear that food was prepared in readiness for anyone who was hungry during the night. Read House offered residents a clean, bright, safe and comfortable environment, with an attractive and well-maintained sensory garden. Handrails were fitted in the home and garden to assist and guide people round. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 6 Read House had a member of staff dedicated to the training and development of staff. Their systematic approach ensured that staff received regular training on a broad range of health and safety and care practice topics. What has improved since the last inspection? What they could do better:
Individual care plans were detailed in relation to health and personal care but needed development to demonstrate that people’s social, spiritual, emotional and recreational needs and preferences were being adequately addressed. A review of day-time staffing levels should also be undertaken to ensure that the home can meet the needs of residents holistically. Arrangements for upholding people’s privacy and treating them with respect were found to be satisfactory in the main and there was no reason think from discussions with staff that they had anything but the best intentions towards residents. However, aspects of practice came to light at this inspection, which warranted review, for example, giving one service user their dentures in the corridor. Particular established routines offered scope for a more person-centred approach. This applied to the times set for people’s baths and two residents commented on this. Although it is recognised that a bathing schedule ensures that every resident has the opportunity to bath, the home should regularly consult with residents about their preferred arrangements. They should also continue to consider how they might alleviate any inconvenience to residents caused by the demand on the passenger lift at mealtimes. The home’s programme of activities and outings were less suited to people with complex needs and the registered persons have been advised to consider how they might access the resources and training to address this. It was noted that most residents remained in their rooms when not engaged in an activity. Whilst this was their choice, one person, who would have preferred the company of others, consequently found little to engage them in the lounge
Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 7 on their floor and spoke of their sense of isolation sometimes. This situation should be addressed through the care plan of the person concerned. Arrangements should be made so that one person, whose room was sampled, is able to reach the call alarm from their bed. The upper floors smelled strongly of bleach and the registered persons should seek advice about the use of this product as a cleaning agent. The registered persons also need to ensure they follow all the required recruitment procedures, including the completion of POVA/CRB disclosures (Protection of Vulnerable Adult and Criminal Record Bureau), before any person comes to work at the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 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 standard(s) above Standards were inspected on this occasion. None of the EVIDENCE: Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10. Individual plans of care were detailed in the areas they covered but not holistic in approach. Suitable arrangements were in place for meeting service users’ heath care needs and ensuring that they received their medication. Generally, arrangements for ensuring that service users enjoy privacy and respect were found to be satisfactory although some areas for reflection and change were highlighted during this inspection. EVIDENCE: Care plans sampled contained detailed information about the individual’s health, sensory and physical care needs but little about their social, emotional, spiritual and recreational needs. For example, one care plan provided only one line about the person’s leisure interests and a reference to their religion. The inspectors also found, after speaking with particular service users, that their care plans did not provide a complete picture of their needs or how the home was addressing them. Care plans included a range of personal and environmental risk assessments, including the potential for falls. A number of staff had recently attended 6
Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 11 hours of training in risk assessment. Plans and risk assessments had been evaluated and updated on a monthly basis although a number of entries in the records had not been dated. The local GP, who attended all but one of the service users, held a weekly surgery at Read House, making use of the dedicated medication room or seeing people in their own rooms, as appropriate. One member of staff reported that the home enjoyed a good relationship with the GP and district nurses and it was noted from records that the GP had contributed to staff training in relation to medication administration. Care plans provided evidence that people’s sensory and skin care needs were addressed and their weight monitored. The home’s activity plan detailed a weekly exercise session although it was acknowledged that this did not fully meet people’s need for exercise and not everyone was able, or chose, to participate. Particular service users walked up and down the corridors for exercise. For those prepared or supported to go outside, the garden was designed to facilitate people with physical and sensory disabilities getting around. The process of administering medication was not observed on this occasion but the Controlled Drugs Register and sample of Medication Administration Records inspected, had been satisfactorily maintained. It was reported that the registered manager ensured that she was available to cover the documentation and processing of incoming medication and returns and that all staff administering medication had undertaken necessary training. The latter point was confirmed in discussion with the training manager and supported by the home’s training schedule and one of the individual training records sampled. It was reported that one person on respite took responsibility for their own medication, which they kept in their handbag by choice. The manager confirmed subsequently that the person concerned had lockable storage in their room. Arrangements for maintaining the privacy and dignity of service users were found to be satisfactory in the main. For example, service users appeared well presented, had use of designated rooms for private consultations and the facility to make telephone calls in private. Service users did not indicate that they had experienced any disregard for their privacy or lack of respect. However, the inspectors noted three examples of practice, which did not appear to promote these core values. Firstly, one service user stated a preference for having their door closed, though it was customary for staff to leave it open (automatic closing mechanisms would be activated by the fire alarm). Another service user was given their dentures whilst seated in the corridor and had been without these most of the morning. Dirt in their fingernails, although accounted for, also suggested some neglect of their care plan that morning. Thirdly, two members of staff were overheard using terms of endearment instead of people’s names and this practice might be perceived as patronising and not be acceptable to everyone.
Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 12 At the last inspection, the registered persons were asked to reflect on the use of notices on dining tables, identifying people’s dietary needs. The registered persons stated that that the decision to retain these notices had been made in consultation with the service users concerned. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 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 standard(s) 12 and 15 Particular routines in the home had potential for a more individualised approach. The home offered a range of scheduled activities but some service users would benefit from a more person-centred approach to how they spend their time. The home catered well for service users’ dietary needs and preferences. EVIDENCE: Although routines were not inspected in detail, the inspectors found that the scale of operations in the home and organisation of the building on 3 floors had led to some standardisation of practices. For example, service users had fixed days and times for bathing and one person expressed some discontent with their allocated slot. Another person said they had accepted having only one bath a week. Management indicated subsequently that the schedule was in place to ensure that everyone who needed assistance had the opportunity to bath but that it was intended to be flexible to accommodate people’s needs and preferences. The inspectors also noted that the demand on the passenger lift at mealtimes meant that service users in wheelchairs might encounter a queue or be taken down to the dining room early to prevent congestion. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 14 Service users benefited from the availability of a mini bus, which had capacity for seven service users at a time. One service user spoke of the pleasure of going on local outings to places such as garden nurseries and coffee shops. Another service user, who also enjoyed the mini bus excursions, regretted not being asked to go on the previous day’s outing when, they understood, not all the places on the bus had been taken. On Tuesdays, service users could also access the day care facilities, attached to the home, as well as attend any concerts that were scheduled. It was evident that service users with particular interests received help and encouragement to pursue them. For example, a shed had been put up recently in the grounds to promote one person’s gardening activity. A weekly activities programme on display showed that something was scheduled for every day but it was evident from observation, discussion and individual records that some service users were and felt under-occupied. This applied particularly to people with limited capacity to take part in organised or self-motivated activities, and their situation highlighted a need for a more person-centred approach to activities, which should be reflected in their care plans. In between activities, many service users remained in their rooms by choice and it tended to be those with more complex needs, who populated the lounges on each floor. Here, it was said, they could be more closely monitored and supported by the staff on duty and engaged in conversation at various times during the day when staff made drinks for everyone. In discussion following the inspection, the manager reported a new arrangement, whereby key workers spent Sunday and Wednesday mornings socialising with particular service users. The inspectors look forward to seeing how this develops at future inspections. Dedicated chefs were employed to prepare meals for the home and day centre. Observation during the inspection evidenced that alternatives were provided and that food was plentiful and freshly prepared. One member of staff advised that a menu was taken round to service users each afternoon, so they could make their choice for the following day. They also commented that food was never short and the kitchen prepared sandwiches, available on each floor, for service users during the night. Cold drinks were available in service users’ rooms and hot beverages prepared in the communal facilities on each floor. One service user with special dietary needs confirmed that they were well catered for and others commented favourably on meal provision. One person’s expressed wish to make their own cups of tea was discussed after the inspection with the registered persons, who had, meanwhile, considered the risks involved. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 15 Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Neither of these Standards were inspected. EVIDENCE: Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 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 standard(s) 19, 20, 24 and 26. Read House offered residents a safe, clean and comfortable environment, suitable for their needs. The scope of the single passenger lift presented some inconvenience for service users. EVIDENCE: Read House was well maintained in all the areas sampled. An accessible, sensory garden at the back of the home, with pond, fountain, handrails and benches was particularly suited to the needs of service users. A number of staff had attended a fire lecture and video presentation in March 2005; it was reported that there were designated fire marshals on each floor and doors had automatic closing devices in the event of fire. A security coded entrance system was in operation at the front of the house. The home offered a large dining room with tables of varying sizes but this was not in use between meals on the day of inspection. It was observed that the compact lounges/kitchen facilities on each of the upper floors were also little used. One member of staff said that service users tended increasingly to
Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 18 remain in their rooms by choice. One person, who would have preferred the company of others, consequently found little to engage them in the lounge on their floor and spoke of their sense of isolation sometimes. This situation should be addressed through the care plan of the person concerned. Handrails were fitted in all the corridors and around the garden. One member of staff stated that they had all the equipment they needed to assist service users with limited mobility, although one inspector noted a wheelchair being used without a foot rest / in a state of disrepair. Call bells did not present a disturbance in volume or duration. One service user was not able to access the call bell from their bed. A number of service users rooms were glimpsed through open doors and three were inspected. All were found to be bright, well decorated, comfortable and homely in their presentation and personalised with the individual’s furniture or belongings. All parts of the home inspected were found to be clean. The home employed dedicated domestic staff and daily and nightly job sheets had been prepared to cover all aspects of cleaning. Heavy use of bleach was identified from these job sheets and in the atmosphere. Laundry was seen to be collected in bags and staff were wearing aprons and gloves whilst assisting service users with personal care. Staff had attended infection control training. One record sampled showed that the person concerned had done a 12-week distance learning course in 2004 and refresher training in June 2005. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30. Day time staffing levels were adequate for meeting service users’ personal care and physical needs, but not always high enough to sustain a personcentred approach to social and recreational activities. The home was not fully adhering to accepted recruitment procedures. Staff were able to maintain their skills through periodic training. EVIDENCE: Staffing rotas were not inspected but the inspectors were informed that the home continued to operate with three staff on the top floor and three serving the middle and ground floors (morning shift until 14.00 hours), two staff on each floor and one floating person (afternoon shift from 14.00 hours) and four awake staff for all floors at night (a ratio reflecting the structure of the building and security arrangements rather than the dependency levels of service users). One member of staff indicated that the arrangements gave them sufficient time to assist service users comfortably. However, one service user said they sensed from an occasional ‘harsh word’ that staff were sometimes under pressure, and so felt reluctant to make requests on their time. When calculating staffing levels using the Department of Health Residential Forum guidance, the registered persons should ensure that their high ratio of staff at night has not obscured a need for more staff during the day. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 20 During the inspection it was observed that staff were engaged in personal care activities and assisting service users to and from the dining room. Although the home employed a number of domestic staff (Monday to Friday) the list of daily duties for care staff also consisted mainly of practical tasks. As previously noted, care plans sampled also indicated that there was scope for developing a more person-centred approach to care in the home. One new member of staff confirmed that they had been interviewed and supplied two references. However, they had still to apply for a Criminal Records Bureau disclosure. Their induction had consisted of a one to one meeting with the training manager on day two of their employment and, at other times, they had been shadowing identified staff on duty under the supervision of an appointed senior. Another member of staff attested to the new recruit being supernumerary in the early stages of their induction. Health and safety, moving and handling, fire safety and working with people with a visual impairment were included in the induction programme. Training records had been computerised. The home’s National Vocational Qualification in care register evidenced that 5 seniors had NVQ Level 3, 8 Level 2, with three more in each category enrolled to commence training in September 2005. Five staff had attained Level 1 and 6 Care Practices Level 2 Distance Learning. Staff were required initially to fund NVQ Level 2 but could expect full re-imbursement if they remained in post. Anyone wishing to undertake NVQ Level 3 was required to fund the training themselves. An analysis of one senior’s training record for the period 2000 to 2005 evidenced 6 to 10 courses annually, with a good balance of mandatory and practice topics, including 7 hours recent training in dementia care. A number of staff had recently attended a series of 6 hour training sessions on a range of relevant topics and most had achieved the appointed person’s first aid certificate. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 The home had taken a thorough approach to staff supervision. EVIDENCE: Senior staff and managers had attended training in supervision and appraisal and time management. Two members of staff spoke about the value of this training for improving the quality of supervision and helping staff to focus and prioritise. Supervision records evidenced regular, practice-based supervision. Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3
COMPLAINTS AND PROTECTION 3 3 x x x 3 x 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x 3 x x Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 23 Yes 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 7 Regulation 15 Requirement The registered persons must ensure that care plans are holistic, detailing how service users emotional, social, recreational, spiritual and cultural needs are to be met. The registered persons must consult individual service users about the homes programme of activities and, having regard to their various needs, provide appropriate support and facilities for recreation. The registered persons must ensure that they adhere to thorough recruitment procedures, including the completion of Criminal Record Bureau disclosures on all paid and voluntary staff. THIS IS A REPEAT REQUIREMENT AND HAS EXCEEDED AGREED TIMESCALES OVER SUCCESSIVE INSPECTIONS. The registered persons must ensure they keep appropriate staff records ie two references per staff member on their file. They must obtain a full employment history for prospective employees, so that Timescale for action 31 October 2005 2. 12, 27 16 31 October 2005 3. 29 19 30 September 2005 4. 29, 37 17(2) 30 September 2005 Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 24 any gaps in employment can be explored. THE INSPECTORS DID NOT HAVE ACCESS TO STAFF RECRUITMENT FILES AND THEREFORE THIS REQUIREMENT HAS BEEN BROUGHT FORWARD. 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 7 10, 15 Good Practice Recommendations The registered persons should ensure that all records are signed and dated. The registered persons should ensure that staff use the term of address preferred by individual service users and ensure that arrangements for their care always promote privacy and dignity. The registered persons should continue to collate service users/relatives wishes in respect of illness and death, where they are happy to provide this information. THIS STANDARD WAS NOT INSPECTED; THE RECOMMENDATION IS THEREFORE BROUGHT FORWARD. The registered persons should ensure that the routines of the home promote individual choice and that service users wellbeing is enhanced by the development of a personcentred approach to activities. The registered persons should ensure that all service users can reach their call alarms from their beds. The registered persons should take advice about the use of bleach in care homes. The registered persons should regularly review staffing levels using a recognised tool, such as the Residential Forum guidance, issued by the Department of Health. 3. 11 4. 12, 20 5. 6. 7. 24 26 27 Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 25 Commission for Social Care Inspection 1st Floor Fairfax House Causton Road Colchester CO1 1RJ 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 Read House I56_I05_s17916_Read House_v217441_UI020805_Stage4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!
