Inspection on 22/01/08 for Rosedene

This inspection was carried out on 22nd January 2008.

CSCI found this care home to be providing an Good service.

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

Other inspections for this house

Rosedene 21/06/07

Rosedene 02/06/06

Rosedene 13/09/05

Rosedene 26/04/05

Rosedene 07/12/04

Rosedene 03/06/04

Rosedene 18/12/03

Similar services:

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Norbury Crescent (30)

Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOMES FOR OLDER PEOPLE Rosedene 141-147 Trinity Road Wandsworth Common London SW17 7HJ Lead Inspector Davina McLaverty Key Unannounced Inspection 22nd January 2008 10:00 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 Rosedene DS0000019117.V352800.R02.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. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rosedene Address 141-147 Trinity Road Wandsworth Common London SW17 7HJ 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) 020 8672 7969 020 8672 3005 terry@rosedene-nursing.fsbusiness.co.uk Mr T Lewis Miss Patricia Barber Care Home 67 Category(ies) of Dementia (67), Dementia - over 65 years of age registration, with number (67), Learning disability (1), Mental disorder, of places excluding learning disability or dementia (67), Mental Disorder, excluding learning disability or dementia - over 65 years of age (67) Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Learning Disability The Home may provide accommodation and care for one named service user with a learning disability only. The category LD is to be removed once this service user is no longer accommodated at the Home. 21st June 2007 Date of last inspection Brief Description of the Service: Rosedene is a registered care home, presently registered for 67 nursing beds for service users with needs including dementia and mental health. The property is located in Wandsworth Common, close to shops, pubs, the post office, bus routes, underground and over ground rail links. The home is on a busy main road, with parking to the front. The property comprises four large three storey terraced houses that have been joined together to form one care home. There are two passenger lifts between all floors. There is a garden to the rear, to the side of which there is a building where activities are provided. The fees range from £616.79 to £1670.25 per week. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The inspection of this service included an unannounced visit to the home on 22nd January 2008, by two regulation inspectors and a pharmacy inspector. The home’s manager, quality assurance manager and proprietor were all available on the day. Documentation looked at included medication records, staff recruitment information, residents care plans and health and safety documentation. We also looked at the premises. The Annual Quality Assurance Assessment (AQQA) completed for the previous inspection was used to help form some of the judgements in this report. We also sent fifteen surveys to the home prior to the visit for staff to complete, of which one was returned. Fifteen questionnaires were also sent to the home to be distributed, on behalf of CSCI to relatives of which five were returned. Fifteen were sent for residents of which ten were returned. All residents had been supported by the activities coordinator to complete their form. Feedback from the surveys on the whole was positive about life in the home. However, due to the small number of questionnaires received from staff, four care staff and one ancillary staff were spoken with during the inspection and they were all positive regarding the operation of the home and care being delivered. Communication with many of the residents proved difficult for the inspectors, due primarily to the level of the people’s dementia or due to the level of their mental health. The managers reported that the home is admitting more residents with a mental health diagnosis. Residents seen throughout the day were appropriately dressed and relaxed. What the service does well: Staff spoken with reported that they worked well as a team to provide a good standard of care to the residents. Comments in the questionnaires received were as follows, “working as a team to cope with the difficult clients we have here” and “ feeds the clients well”. Relatives stated, “ has good hygiene”, Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 6 “good catering”, and “keeps me informed of any problems”. Others said “provision of personal care”, and “care for its residents very well”. The work of the activities co-ordinator enhances resident’s life in the home, as a variety of activities are offered. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 7 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 Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 8 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): 3&6 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Assessments are completed before people move into the home, in order to make sure that their individual needs can be met. EVIDENCE: There is a comprehensive assessment procedure in place, which includes several visits to the home for the prospective person and their representative, where possible. Examination of two new residents files, evidenced finding at the previous inspection that no resident is admitted without a comprehensive assessment. Care managers assessment reports were in place, as well as the home’s own Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 9 assessment report. Information seen in files were organised, easy to locate and easy to read. Sufficient information was seen on files regarding the assessment of the persons care and support needs, including reports from various professionals involved with the person e.g. CPN s, physiotherapists. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are in place and are being reviewed regularly. There is evidence of multi-disciplinary working with healthcare professionals. EVIDENCE: Care plans for six residents were examined. Care plans seen were being maintained and updated regularly. Care plans led from the individual’s assessment and were comprehensive and easy to follow. Plans also contained clear, personal information on the resident’s next of kin, GP and their medication. Care plans were seen to be reviewed monthly by staff. A daily living profile was also seen, as well as background information regarding the person’s earlier life, which provides a pen picture of the resident, which is Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 11 helpful. The managers reported that sometimes it can be difficult to get life history information, particularly if there is no family/friends currently involved with the person. Assessment information gathered, covered appropriate areas relating to daily living i.e. communication, breathing, and mobility. Information also gathered about residents’ sexuality. Mental health assessment was also seen to be in place for those residents who suffer with a mental disorder. As stated earlier, inspectors found that communication with some residents was difficult due to their level of dementia or mental disorder. However, those spoken with said that they were ‘alright’. A new resident said that they liked it at Rosedene. They showed us their bedroom, which was personalised with magazine cuttings, pictures and ornaments. Risk assessments are in place around the area of falls, injury to self and others and environmental issues e.g. whether the person requires bedrails or not. Staff ensure that where bedrails are to be used, that either the person who the risk assessment relates to signs the assessment, or their next of kin/care manager. However, this was found not to the case on one of the files examined where the assessment was not signed by the resident or relative. Also, there was no evidence of involvement from a health care professional such as Occupational Therapist or Care Manager. There were nine requirements on medication handling in the last report. The home has made good progress in this area and all requirements have been met. Monthly audits are being carried out by the Manager and members of staff have been given areas of responsibility, which are checked weekly e.g. to ensure records are completed accurately and to ensure all medicines are in stock etc. There are charts displaying when injections are due, so no injections have been missed. There were no medicines out of stock on the day of the inspection. There were no gaps on medication records, administration, receipts and disposal of medicines were being recorded. There is a clear audit trail of medicines into and out of the home, and all medication is stored securely. There were a number of minor issues with medication, which did not impact on the safety of residents. A list of these were given to the Manager to assist with further improving medication handling and some recommendations have been made to further improve medicines management. The National Service Framework for older persons recommends that a medication review is carried out every 6 months for all residents over 75 years old taking 4 or more medicines. This applies to most of the residents at the home. There is evidence that sedative medication is not being overused, although it is not always clear why a dose of as required “prn” medication has been given. One resident has been prescribed a spray for angina. This spray is kept locked in the medicines trolley. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 12 For the same resident, a document on how to deal with chest pains has been obtained from the hospital. Some of the actions to be taken do not apply to care home settings. This must be re-written so that it is specifically for use by care home staff. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Residents receive a wholesome and balanced diet in pleasant surroundings. Dietary needs continue to be well met and food looks well prepared and nutritious. Relatives are encouraged to maintain contact with relatives and friends. A varied programme of activities for residents is now in place. EVIDENCE: As stated at the previous inspection, a full time activities co-ordinator is in post at the home. The home has a separate activities room in the garden, which is well resourced with arts and craft materials, books, newspapers, sewing materials, television and DVDs. Activities are varied, as well as individual e.g. there are reminiscence mornings, discussion on local events, current news, as well as art and crafts sessions, some of which is displayed in the recreation room, as well as around the home. There are also film evenings and baking sessions, as well as regular Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 14 local outings to church, which took place on the day of the inspection. A member of staff stated that arts and crafts had taken place on her unit that morning. The quality assurance manager spoke of activities over the Christmas, which included a theatre group re-enacting the story of “Little Red Riding Hood”, which was audience participatory. Halloween had also been acknowledged with some residents dressing up and playing games e.g. apple bobbing, which inspectors were informed residents had really enjoyed. The Assurance Manager showed inspectors comments written by residents, which she is intending to insert in the home’s welcome pack for new residents. Residents meetings are held monthly. There had been some improvement on the recording of these meetings, but inspectors felt that there is stillroom for improvement. Residents seen appeared content. Several, when spoken to, said that they “liked the home, the staff were kind, and the food was good. One new resident said they found the home to be “alright”. The Annual Quality and Assurance Questionnaires (AQAA) said, “that the home encourages residents with capacity to handle their own financial affairs. We also maintain our policy of encouraging all residents to bring any possessions that would make their living area more personal”. Personal possessions was seen in a couple of the rooms sampled. The managers stated that many of the residents do not have a lot of money and therefore personalisation of rooms can be difficult. Lunch was observed, with residents being offered a choice of meals. However, one resident spoken with said that they did not like the lunch, stating that it “was not the food I like,” but failed to say any more. Residents can choose where they eat. There is a large dining room on the ground floor. Alternatively, residents can have their meal on their units. Tables have been put in these lounge areas to enable residents to eat communally if they wish. Small tables are also available however, many of these require replacing a they were chipped/ badly marked in places. Residents who require an apron should be provided with something more appropriate. Consideration must be given to providing large cloth napkins, in place of blue plastic aprons, to make sure that residents are respected. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure, which is known by residents and their representatives. Safeguarding adults procedures are also in place. EVIDENCE: The home’s complaint procedure is detailed in the home’s ‘Statement of Purpose and Service User Guide’, which residents/representatives can request on admission. A copy of the procedure is displayed on the home’s notice board and the quality assurance manager stated that at residents meetings residents are encouraged to say what’s on their mind. The manager stated that there have been no formal complaints since the previous inspection. Three of the five questionnaires received from relatives/carers/advocates stated that they knew how to make a complaint. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 16 There have been no investigations under Protection of Vulnerable Adults procedures since the previous inspection. Induction training includes Protection of Vulnerable Adults training. Staff spoken to were aware of the steps to be taken in the event of abuse being identified. A copy of Wandsworth Safeguarding Vulnerable adults was available in the home. Rosedene DS0000019117.V352800.R02.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): 19,20,21,23,24,25 & 26 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. This home continues to provide residents with a comfortable place to live. Maintenance work is ongoing and a refurbishment programme is in place. The home was clean and hygienic on the day of the inspection. EVIDENCE: This home has accommodation that is arranged over three floors and has two passenger lifts that serve the floors. Refurbishment of the premises was in hand with new radiator guards being fitted. The quality assurance manager stated that several bedrooms had been Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 18 redecorated since the last inspection and that a rolling programme of maintenance and refurbishment of rooms is on going. One staff spoken with said that the décor could be improved. There are 18-shared bedrooms and screens on wheels are available in each room to provide a degree of privacy, particularly when personal care is being carried out. In discussion with the managers, screen should be replaced, as they are institutional in appearance. The managers acknowledged this and said that this was currently being addressed. Consideration must also be given to the type of beds used and bed linen. Inspectors noted that beds were very old fashioned and institutional in appearance i.e. metal with the top legs on wheels with plastic mattresses. One bed had a hospital blanket on it. This was raised with the manager and the proprietor who agreed to discuss this with the occupational therapists in regards to recommending more appropriate beds in view of residents physical needs. Many bedrooms were sparsely furnished, which staff stated were resident’s choice and that many items of furniture often got damaged due to some residents challenging behaviour. Bedrooms have linoleum flooring, single beds, wardrobe, chest of drawers and a wash hand basin. A couple of bedrooms seen had been personalised. Staff stated that where relatives were involved, they tended to input into how their relative’s room looked. Some bedrooms seen included pictures and had been personalised by the individual or their relatives, while other bedrooms were very bare. In discussion with staff and managers, they stated that due to some resident’s mental health, they do not want their room personalised or even decorated and the home has to respect the rights of residents to decline to have their rooms decorated. Inspectors advised that this be raised at reviews and recorded. Residents spoken to all said that they were happy with their rooms and had no complaints. None of the questionnaires received expressed concerns about the resident’s individual environment. The conservatory area remains the designated smoking area, as well as the garden, which is quite large, well maintained and is well used by residents throughout the year. A large sign on the conservatory door identifies the area for smokers. Staff must ensure that the door is closed soon after someone enters, as the smell of smoke could be smelt in the adjoining large lounge. A laundry area and hairdressing area is available. The home was clean, hygienic and free from offensive odours on the day of the inspection. One member of ancillary staff is responsible for each floor of the home. Several relatives in their questionnaires commented on the cleanliness of the home. However, inspectors noted that one of the staff when taking their Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 19 break, locked their cleaning trolley into a resident’s room, which is not appropriate. Resident’s rooms must be respected. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 20 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): 27,28,29 & 30 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of staff are employed, which is kept under review depending on residents assessed needs. Recruitment practices ensure that appropriate checks are carried out prior to staff being employed. Internal and external training is provided to make sure that staff has the necessary skills to care for residents. EVIDENCE: Files for three new staff were examined and evidenced that all the appropriate checks had been carried out. A confirmation letter was seen from an agency that sends staff on placement to the home that appropriate checks will be carried out prior to anyone being sent to the home. On the day of the inspection, inspectors spoke to a student on placement who spoke positively of her time in the home. She said her role was to observe, talk to residents but would give personal care. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 21 Since the last inspection, all nursing staff have received training in wound management and diabetes care. In discussion with the quality assurance manager and homes management training is a priority in the home. A lot of training is accessed locally through Wandsworth Social Services, which includes dementia care, dealing with challenging behaviour and mental health. An appropriate induction programme is also in place, which meets with Skills for Care criteria. The manager maintained that training is discussed during supervision and during staff meetings. Surveys received indicated that respondents thought there were suitable numbers of staff and that staff are helpful and do a good job with a vulnerable group of people. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 22 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): 31,33,35, 37 & 38 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager continues to provide clear direction and leadership. Staff supervision has improved, ensuring that staff have the support they need to carry out their roles. Health and safety systems are in place to ensure the safety of residents and staff. EVIDENCE: Relatives and staff in their surveys were positive about the home and care given. The manager is experienced and has worked in the home for over 25 Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 23 years in various roles. Senior staff spoken with stated that the home is receiving more referrals from social services to support people with a mental disorder rather than dementia. Staff stated that despite some having challenging behaviour the change in client group is leading to younger adults been accommodated and supported, who want to participate more in the life of the home. Activities being provided is therefore constantly being reviewed. Staff spoken to and in the questionnaires received, stated that they felt their views are listened to and they are encouraged during team meetings to raise any issues positive or negative. Policies and procedures are in place in respect of the management of resident’s finances. A quality assurance survey in now in place with questionnaires having been sent to other stakeholders. Comments received back at the time of the inspection was positive, one survey seen stated that their view the care was “excellent”. Responses must be collated and a brief report written regarding the responses from all stakeholders and any action taken. Health and Safety records indicate that routine checks are made on electrical equipment, gas safety and fire alarm installations. However, fire alarm tests must be carried out weekly and not monthly to ensure everyone’s well-being. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 3 2 Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 25 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 OP10 Regulation 13(4) Requirement Staff must ensure that storage trolleys are not stored in resident’s bedrooms whilst breaks are taken. Fire alarms must be tested weekly and a record maintained. Timescale for action 01/02/08 2. OP38 23(4)(c) 01/02/08 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 OP7 2 3 OP9 OP9 Refer to Standard Good Practice Recommendations Where residents require bed rails, the resident/advocate or a representative for the person should sign the risk assessment. The home should record when medication reviews are carried out. It is recommended that whenever a dose of sedative medication prescribed on an as required basis is given, that staff record the reason in the daily notes, as well as the alternative strategies used before resorting to medication. It is recommended that medicines for emergency use are DS0000019117.V352800.R02.S.doc Version 5.2 Page 26 4 Rosedene OP9 kept by the resident where possible to avoid any delay in obtaining treatment. 5 6 7 8 OP15 OP19 OP24 OP24 Senior staff must ensure that an alternative to blue plastic aprons is sourced, for residents to use at mealtimes. Consideration should be given to different ways to label residents bedrooms. Consultation should take place with an occupational therapist regarding appropriate beds for residents. Appropriate screens must be provided in the double rooms, which provide more privacy for residents. Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Rosedene DS0000019117.V352800.R02.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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