Inspection on 21/09/06 for Sharnbrook Lodge

This inspection was carried out on 21st September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sharnbrook Lodge 31/01/08

Sharnbrook Lodge 23/08/07

Sharnbrook Lodge 30/05/06

Sharnbrook Lodge 22/11/05

Sharnbrook Lodge 24/05/05

Sharnbrook Lodge 18/11/04

Sharnbrook Lodge 18/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Sharnbrook Lodge 17a Park Road North Houghton Regis Bedfordshire LU5 5LD Lead Inspector Leonorah Milton Unannounced Inspection 21st September 2006 09:10 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 Sharnbrook Lodge DS0000014966.V312990.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. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sharnbrook Lodge Address 17a Park Road North Houghton Regis Bedfordshire LU5 5LD 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) 01582 866708 Mr John Philips Mrs Miriam Philips Mrs Jean Flanagan Care Home 12 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (12), of places Physical disability over 65 years of age (12) Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th May 2006 Brief Description of the Service: Sharnbrook Lodge was a privately owned residential care home. The service was registered for twelve older people who may also have dementia and/or physical disabilities. The building was a detached property situated on a main thoroughfare that provided direct access from Luton, Dunstable and Houghton Regis. The home was in close proximity to local shops and other amenities. There was parking for several cars to the front of the premises and a large garden at the rear of the building that was be accessible to service users. A large lounge/diner was located on the ground floor. The premises had undergone major building works to increase the number of bedrooms and facilities throughout. Twelve additional bedrooms with ensuite facilities, additional bathrooms, and a lounge/diner had been added to the premises along with a new entry, kitchen and additional parking spaces. The inspection visit included assessment of the new build. The registration was subsequently amended to increase the registration to provide for twenty-four older persons who may have dementia and/or physical disabilities. Fees for accommodation were between £425 and £475. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report sets out the significant evidence that has been collated by the Commission for Social Care (CSCI) since the last visit to and public report on, the home’s service provision in May 2006. This report comments on improvements to the home since that visit and reiterates the evidence seen at the previous inspection in relation to good practice. Reports from the home and other statutory agencies, and information gathered at the site visit to the home, which was carried out on 21st September 2006, were taken into account. Eleven service users were living in the home on the day of the visit. The inspection included a review of the case files for two service users, conversations with two service users, a visitor, a member of staff, the manager and the proprietor. Much of the time was spent with service users in the ground floor lounge/diner, where the daily lifestyle was observed. A tour of the building to include the new extension was carried out and other records were reviewed. What the service does well: What has improved since the last inspection? Action had been taken on requirements from the previous report to improve documentation in relation to service users’ care needs. Safety arrangements had been improved by action taken to remove hazards of accidental burn from unprotected radiators and access to hazardous substances and razor blades. Work had been carried out to ensure that fire doors closed onto rebates but it was noted that the fire resistant sealant to one was not in place. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 6 Recruitment practice had improved to ensure that staff of the right calibre had been employed to care for service users. A training system to provide personnel with comprehensive induction training had commenced. The environment had been greatly improved by the completion of an extension and other refurbishment works. What they could do better: Action must be taken on outstanding requirements: Provide a suitable set of scales must be provided to ensure that each service user can be weighed on a regular basis. Recreational activities must be available for service users on a regular basis and meet their needs and abilities. Medicines requiring storage under refrigerated conditions must also be stored securely. Bathrooms and toilets must be provided with suitable door locks. The manager must undertake training in relation to the management of a service to those with dementia. Issues for action identified at this inspection included: A hygienic system to transport meals from the kitchen must be introduced which also ensures that food is served at safe and appropriate temperatures. Fire doors must be fitted with fire retardant sealants that comply with safety requirements. Information about previous employment history must be obtained before new personnel are appointed. A report and action plan must be drawn up in response to the annual quality audit process. Staffing arrangements and the written guidance to the home must be adjusted to reflect the changes in the operation of the home at the registration of additional places and admission of service users to those places. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 7 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. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Satisfactory information about service users’ needs had been obtained before service users had moved into the home to ensure that the home had the ability to meet assessed needs. Individual contracts were in place to inform service users about the conditions for their accommodation in the home. EVIDENCE: Two case files were assessed at the previous inspection visit and two others were assessed at this inspection visit. Records indicated that sufficient information had been obtained via the care management procedures of placing authorities before service users had been admitted to the home. Contracts were in place on each case file assessed. They had been signed on behalf of service users’ by their representatives. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 10 The home did not provide an intermediate service. The statement of purpose must be revised to take account of the changes to the homes registration. The statement must show how many bedrooms can be accessed by wheelchair users. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Care planning documents seen at this inspection contained sufficient guidance to enable staff to care for service users. EVIDENCE: Two care plans were assessed at the visit carried out on 21st October 2006. Each contained an assessment of need and corresponding care plan that covered the details laid out in the National Minimum Standards. Progress had been made on some plans to note the wishes of service users in the event of terminal illness or death. Whilst assessment of nutritional needs were in place, personnel in the home had not been able to monitor weight gain or loss in all instances because the home was without scales that could be used by service users with mobility problems. The inspector was informed that these were on order. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 12 Records seen at the previous inspection indicated that, “service users had been supported with their health care needs. Service users confirmed that they had been referred to their doctor as need be and that they had received routine chiropody and optical treatment. It was difficult at this inspection to readily assess records of healthcare support because documents were not organised into each individual case file. It is recommended that individual, sequential records of healthcare appointments and treatments be maintained in case files for audit purposes.” The previous inspection had identified that medication practices were satisfactory with the exception for the arrangements for storing medications in the kitchen fridge, “Medications were stored securely in the manager’s office. Records assessed and compared with stocks of medications showed that medications had been given as prescribed. Records were seen that showed that staff with the responsibility of administering medications had undertaken distance-learning courses in safe practice. It was noted that medications for storage under refrigerated conditions were stored in the food refrigerator. Such medicines must be stored securely.” The inspector was informed at this inspection visit that a refrigerator for medication storage was on order. Sharnbrook Lodge DS0000014966.V312990.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the home. Arrangements to provide service users with activities for stimulation and entertainment had improved after the last visit. However the provision had been inconsistent, so that service users had not had the opportunity to take part in meaningful activities for much of the time. The hygiene arrangements for the transportation of meals from the kitchen were unsatisfactory and had increased the risks of food contamination. EVIDENCE: At the most recent visit to the home it was noted that records of activities for recreation and stimulation had been introduced from 27th June 2006. The records indicated the provision of board games, quizzes, talking tapes, music and dancing and reminiscence sessions. There were however no records of such events after 13th August 2006 until the day of the inspection visit. The report of the previous inspection had noted, “Service users confirmed that their visitors had been made welcome in the home. A visitor was complimentary about the care his relative received and stated that his family were encouraged to visit. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 14 Menus indicated that service users had been provided with a nutritious diet. Conversations with a carer showed that she was aware of special diets and infection control procedures in the kitchen.” Only of the two service users spoken to at the second visit to the home was able to express an opinion about the meals served to them. The service user stated that these were good and that they enjoyed their food. They commented that fresh fruit was available but said that they would prefer a little more vegetables to be served with their med-day meal. At the most recent visit it was noted that service users were served plated meals at the mid-day mealtime. The plates were not covered for hygiene purposes as staff carried them along the corridors from the kitchen to the dining room. Sharnbrook Lodge DS0000014966.V312990.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Procedures were in place to enable service users to raise concerns. Protection procedures had improved since the last visit to the home and showed that service users were no longer subject to the risks that can arise from failures to obtain checks on criminal history during recruitment of personnel. EVIDENCE: The previous report had commented, “The manager reported that no complaints had been made since the last inspection. Service users confirmed that they felt they could raise concerns if the need arose. The complaints procedure was seen. It covered the details specified by the legislation. Records indicated that personnel had received training in adult protection procedures. However protection procedures in the home had been compromised because there had been a failure to obtain a criminal records check (CRB check) and a similar check via the Protection of Vulnerable Adults Register (POVA First check)”. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 16 Assessment of personnel files at the most recent visit showed that satisfactory reports from the Criminal Records Bureau had been obtained before personnel had commenced employment in response to requirements from the last report. Sharnbrook Lodge DS0000014966.V312990.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,24,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Whilst there were outstanding issues in relation to privacy arrangements and fire safety, the plans in hand meant that these issues would not adversely impact on service users for long. The overall standard of the environment had improved significantly and met service users’ assessed needs. EVIDENCE: The premises had been undergoing significant change for several months. An extension to the side of the building had been completed to a high specification that had taken account of the National Minimum Standards for safety, space and facilities. All of the bedrooms in the new build were spacious and had roomy ensuite toilet and washbasin facilities. One of the bedrooms was large enough to accommodate a married couple or siblings wishing to share. The building works had included the provision of a new kitchen, laundry room, combined staffroom/hairdressing room, office and the refurbishment of an existing lounge, bathroom and some bedrooms. The proprietor was advised Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 18 that he should fit screens to the windows of the kitchen to deter the entry of insects. The previous report had noted, “The doors to the toilet and bathroom in use at this inspection were without useable locks. Several bedroom doors were fitted with locks that required an “alleyne” type key to secure them. This did not meet the standard for service users to be supplied with individual keys to their rooms. Where it is not practical for service users to hold keys to their bedrooms their case file must contain a risk assessment to qualify the withholding of a key.” Action on requirements arising from these issues had not been sufficient. It was noted at this visit that some bedrooms and a bathroom were still without suitable locks. The manager reported that some action had been taken to carry out risk assessments in relation to service users’ abilities to hold keys. Although action had been taken to ensure that fire doors closed fully onto their rebates, there were still risks in the fire safety arrangements. The fire retardant seal that limits the spread of fire was not in place on the edge of the door leading into the lounge/diner in use at the inspection. The seal on the edge of one door to a bedroom in current use had been painted over. One service user expressed concern because they had been moved to a smaller bedroom during the refurbishment. This was discussed with the manager who stated that the service user would be accommodated in their original room once works had been completed. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Sufficient numbers of personnel who understood how to meet service users’ needs properly were on duty each day. Whilst recruitment practice had improved there were still laps in the good practice required to ensure that employees were suitable to work with vulnerable people. EVIDENCE: Rotas seen at this visit indicated that two care staff had been on duty throughout the days and evenings to care for the eleven service users in residence. One waking member of staff and one sleep in member of staff had been scheduled on duty each night. A domestic assistant worked three hours each weekday and a cook worked four hours each day. It was concerning that care staff were carrying out the catering duties each morning in addition to the busy schedules at these times to care for service users. The proprietor agreed by letter to the Commission to increase these staffing arrangements at the admission of any other service users. Sufficient care staff must be scheduled at day and night to care for service users. This must include two waking night staff and a cook to prepare all meals. Recruitment procedures had improved as detailed previously in this report. The employment application form must be revised. Applications seen at this Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 20 visit did not contain a section in relation to previous employment and the relationship of referees to the applicants. The previous inspection visit had included assessment of the training provision, “Staff had been provided with statutory training but initial induction training was inadequate. The personnel file for one carer showed that she had received induction to TOPSS standards, however on enquiry to the carer it was explained that this had been a brief course provided by an agency, which had not met required standards……… Training to achieve National Vocational Qualifications (NVQs) was progressing despite the home, in common with others in this area, having had difficulties with a local college, who had failed in its contract to properly assess candidates for NVQs. The manager reported that after this disappointing setback staff had been enrolled with another college and were working hard towards the award. Of the fourteen staff, one held an NVQ at level 3, two held awards at level 2 and four were working towards the qualification at level 2.” Records seen at the most recent visit showed that the provision of statutory training had continued. The inspector was shown a format to provide comprehensive induction training and informed that this had been commenced with new personnel. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The manager showed commitment to the service users’ welfare and had strived to manage the home effectively. The shortfalls to the service delivery that are within her brief could be readily solved and result in an improved standard of care for service users. EVIDENCE: Evidence noted on the report of the previous report in relation to the manager’s experience and knowledge was still relevant; “The manager had held a certificate in management for a number of years and had worked in a management capacity for several years. She explained that she had undertaken a half-day course in understanding dementia care along side her staff. Given the home’s registration to care for those with dementia and indeed the number of service users with cognitive impairment living in the Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 22 home, the manager must under take more comprehensive training to manage the delivery of such a service. It is also recommended that she undertake other management training to ensure that she is fully prepared for the management of a larger operation when the home doubles its size at the registration of the new build. The proprietor must also properly support the manager. Whilst it was reported that the manager met frequently with the owners of the home there were no systems in place to provide her with formal supervision.” At this inspection the manager stated that she planned to commence training in the management of a dementia care service in the near future. Formal supervision had been provided for the manager since the previous inspection. The report also commented “The manager was spoken of highly by the service users, the staff on duty and the visitor to the home. Whilst there were no formal meetings with service users to gauge their opinions, the manager showed, during conversations with the inspector, that she was well acquainted with service users and understood their needs. The manager stated, where possible service users, had completed quality assurance questionnaires and that these were on case files. However there were none on the two case files assessed at the inspection visit. Formal systems to consult with service users, or where appropriate their representatives, must take place in addition to the informal systems currently in place. A resulting action plan must be made available to service users and the Commission.” At the most recent inspection the inspector was informed that questionnaires had been circulated to service users and their representatives and that a report would be drawn up when the documents were returned. As the occupancy of the home increases, it is suggested that regular meetings with service users and/or their representatives be introduced. It was noted on the previous report that arrangements for service users’ personal monies were appropriate, “ Records for personal monies held for two service users were assessed and showed that the home held only small amounts of cash to settle bills for hairdressing and chiropody services. Appropriate records had been maintained for these transactions.” As recommended in the previous report, the increase in occupancy will require a more professional approach to the management of the home. The senior team must be developed in size and skill to support the manager. The manager was currently on call throughout her absences from the home. This arrangement is not ideal or practical. Other senior personnel must have the capability and availability to take on some of the on call responsibilities. Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x 2 x x 2 x 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 2 Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP12 Regulation 12(1)(a) 16 (2) (m) Requirement Arrangements must be made to ensure that all service users receive adequate stimulation to ensure they are motivated. (Progress noted but previous timescales of 30/01/06 and 30/07/06 had not been met in full) Timescale for action 31/12/06 2. OP8 12(1)(a) 16(2)(c) A suitable set of scales must be 30/11/06 provided to ensure that each service user can be weighed on a regular basis. (Previous timescale of 31/08/06 had not been met) Medicines must be stored securely. This must include medicines stored under refrigerated conditions. (Previous timescale of 30.09.06 had not been met) A hygienic system to transport meals must be introduced which also ensures that food is served at safe and appropriate temperatures. Doors to toilets and bathrooms must be provided with DS0000014966.V312990.R02.S.doc 4. OP9 12(1)(a)1 3(2) 31/10/06 5. OP15 12(1)(a) 16(2)(g) (j) 12(1)(a)2 3(1)(a) 30/11/06 6. OP21 31/10/06 Sharnbrook Lodge Version 5.2 Page 25 7. OP24 12(1)(a) 14 8. OP27 12(1)(a) 18(1)(a) 9. OP29 12(1)(a) 19 10. OP31 12(1)(a) 18(1)(c) 11. OP33 12(1)(a) 24 12. OP38 12(1)(a), 23(2)(4) (c)(i) appropriate locks. Previous timescale of 30.06.06 had not been met) Where it is not practical for service users to hold keys to their bedrooms their case file must contain a risk assessment to qualify the withholding of a key (Previous timescale of 30/07/06 not met in full) Staffing arrangements must be increased at the admission of anymore than twelve service users. Sufficient care staff must be scheduled during the day and night to care for service users. This must include two waking night staff and a cook to prepare all meals. Recruitment records must show that applicants have provided information about previous employment and their relationship to referees. The manager must undertake training in relation to the management of a service to those with dementia. (Previous timescale of 30.09.06 had not been met) Procedures to assess the quality of the service on at least an annual and which involve formal consultation with service users and their representatives must be introduced. (Progress noted but previous timescale of 31.08.06 had not been met in full) The registered person must ensure that fire doors throughout the home are fitted with fire retardant seals that comply with fire safety requirements. 30/11/06 30/10/06 30/10/06 31/01/07 30/11/06 30/10/06 Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP1 Good Practice Recommendations The statement of purpose should be amended to include the changes to the home’s registration that were agreed after the inspection. The statement should show the number of bedrooms that can accommodate wheel chair users. Arrangements should be made to ensure the wishes of service users in the event of their death are recorded (Carried forward from the previous two inspections.) It is recommended that that a medication refrigerator is provided for the secure storage of medicines. (Carried forward from the previous inspection) The manager and staff should undertake training in the provision of recreational activities for older people, to include appropriate activities for those with dementia. (Carried forward from the previous inspection.) Screens should be fitted to the windows of the kitchen to deter the entry of insects A hand washing sink should be installed in the laundry room. The manager should not be scheduled to carry out all of the on call duties. These responsibilities should be shared with other senior personnel. It is suggested that regular meetings with service users and/or their representatives be introduced. The manager should consider undertaking training to achieve the Registered Manager Award. (Carried forward from the previous inspection.) The manager should consider embarking on further care planning training. (Carried forward from the previous two inspections.) 2. OP11 3. 4. OP9 OP12 5. 6. 7. 8. 9. 10. OP19 OP26 OP27 OP33 OP31 OP31 Sharnbrook Lodge DS0000014966.V312990.R02.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Sharnbrook Lodge DS0000014966.V312990.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. 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