Inspection on 24/11/08 for Snapethorpe Hall

This inspection was carried out on 24th November 2008.

CSCI found this care home to be providing an Adequate 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

Snapethorpe Hall 02/05/07

Snapethorpe Hall 23/05/06

Snapethorpe Hall 16/01/06

Snapethorpe Hall 30/08/05

Snapethorpe Hall 29/09/04

Snapethorpe Hall 07/06/04

Similar services:

Snydale Care Home

Staveley Birk Leas Nursing Home

Fairmount Nursing Home

Currergate Nursing Home

Brookfield

Castlethorpe Care Home

Elmleigh Convent

Woodlands Respite Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

CARE HOMES FOR OLDER PEOPLE Snapethorpe Hall Snapethorpe Gate Broadway Lupset West Yorks WF2 8YA Lead Inspector Susan Vardaxi Key Unannounced Inspection 24th November 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 Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Snapethorpe Hall Address Snapethorpe Gate Broadway Lupset West Yorks WF2 8YA 01924 332488 01924 332499 snapethorpehall@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Ltd 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) Care Home 62 Category(ies) of Dementia - over 65 years of age (62), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (62), Physical disability over 65 years of age (62) Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 31 beds for the combined categories of MD and DE Can provide accommodation and care for a named service user under 65 years of age. 2nd May 2007 Date of last inspection Brief Description of the Service: Snapethorpe Hall is a purpose built residential care and nursing home, which provides places for up to 62 older people who may also need nursing care or have a physical disability or who are suffering from dementia. The home is divided into two separate units over two floors, one providing care for elderly mentally ill people and one providing general nursing and personal care. All bedrooms are single en-suite and each floor has its own lounge and dining room. From the hallway and downstairs lounge, a very pleasant patio and garden area can be accessed. The home provides a passenger lift for those who require it and allows easy access to both floors. The home is situated on the outskirts of Wakefield, is easily accessible from the M1 motorway and there is a regular bus service to the city centre. Car parking is available to the front of the home. An activities programme, including organised outings, is available and is co-ordinated by the homes activities organiser. The home employs the services of a visiting hairdresser who is available several times each week. The provider informed the Commission for Social Care Inspection on 24th November 2008 that the fees range from £388 to £670 per week. Additional charges include hairdressing, private chiropody, newspapers and some selected activities. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Service users can access these and inspection reports from the home. Snapethorpe Hall DS0000006209.V373373.R01.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 1 star – adequate service. This means that the people who use this service experience adequate quality outcomes. This was an unannounced visit to the home, which was completed by two inspectors on the 24th November 2008 over seven hours commencing at 10am. During the visit the inspectors spoke with some people living at the home, a relative, some staff, the manager and operations manager. Information has also been included that was received on surveys completed by three relatives, people living at the home, a health professional and by the service after the visit Since the last visit nine safeguarding incidents involving incidents between people who live at the home and one involving two staff against a person living at the home have occurred. The management had referred the incidents appropriately under Wakefield Metropolitan District Councils Safeguarding procedures. Two complaints were also investigated appropriately through the homes complaints procedures. The inspector would like to thank the people who live at the home, their relatives/representatives, the manager, operations manager and staff for their cooperation and hospitality during this visit. What the service does well: People who live at the home and their relatives spoken with made some positive comments about their care and no concerns were raised during the visit. People spoken with said its very good here, its alright here no complaints”. Comments made on surveys received included very well looked after and the staff are always on hand for any emergency however small People have a choice of meals and always get their medication on time. The home is generally cleaned and decorated to a good standard and a rolling programme for re decoration is in place. A four-week menu offers a choice of meals throughout the day. Generally comments about meals varied some were positive others included meals arent varied enough, doesnt always get the diet of their choice. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 6 People are able to take in some of their personal possessions including photographs, ornaments and pictures, which were on display in their bedrooms. Meetings are held with the people who live at the home and provide the opportunity for those who are able to voice their views. The staff spoken with said they had plenty of training. What has improved since the last inspection? What they could do better: A new manager has been appointed since the last visit on the 2 May 2007 who is working towards making the improvements to the service, which will ensure a quality, care service is provided. The staffing levels on all units at night must be increased and the staffing levels during the day kept under review to ensure peoples needs are met and they are safe. Staff induction training needs be extended from the current two days provided to ensure people have the knowledge and skills to meet peoples needs appropriately. Staff should speak to people and assist them with all aspects of their care in a manner, which respects their rights, their privacy, and dignity. Comments received on surveys included Staff could talk to people more, rather than just plonk meals in front of them However, a person had considered some staff did not have a good attitude. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 7 Information obtained prior to people being admitted to the home needs to be recorded so that staff have access to accurate information Care plans and risk assessments need further development to ensure peoples needs are met and they are safe. Incidents that occur in the lounges between people who live at the home must be better managed by staff to ensure people are not harmed and are protected. Some entries on medication records need to be improved to provide an accurate audit trail. Staff should check to ensure the dividers on the medication blister packs do not adhere together to prevent the wrong medication being given to people. Activities should be provided which meet peoples needs, choices, preferences and abilities so that they are stimulated and motivated. People should be asked to confirm that they are satisfied with the outcomes of complaints made to the home. The carpet in the smoking lounge needs to be replaced and the registered person should seek the advice of the fire officer regarding the type of floor covering needed to prevent fires occurrring. 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. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre admission assessments are completed however, information obtained at the time of assessment needs to be recorded fully, signed and dated to confirm agreement and accuracy of the information. EVIDENCE: Some records seen showed that assessments had been completed prior to people being admitted to the home. However a persons assessment did not include their date of admission, the assessment form had not been signed and dated and was and lacking in pre admission assessment detail. The home does not provide intermediate care. Snapethorpe Hall DS0000006209.V373373.R01.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are completed however, some need further development to ensure peoples needs are met, their rights, privacy and dignity are respected and they are safe. EVIDENCE: Care plans and risks assessments had been completed on the records seen, however some need to be reviewed to ensure peoples needs are met and they are safe. The manager said he was working to review the information on all peoples care plans, some of this had occurred. However, the revised and new care plans were stored on the same file which could lead to staff accessing inaccurate information and peoples needs not being met. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 11 The size of the sling needed when the hoist was used had not been included in a person’s care plan. A person’s care plan for continence control only referred to pads being used change when wet and did not include the action needed by staff to try to promote continence and help them keep some independence regarding meeting their needs. A risk assessment for the use of bedrails for a person at risk of falling out of bed had been completed when their daily records stated on one occasion the bedrails were found down, and on another occasion staff found them on the floor. The risk assessment for a person included that they were at risk of climbing over the bed rails, however, on one occasion they had been found with their legs between the mattress and bedrails. A risk assessment had not been completed for one person who was known by staff to exhibit some sexually related behaviour. A persons’s daily records stated that they had slipped off the bed whilst a carer was reaching for a towel and face cloth. Their care plan did not include that two staff were needed to assist them with washing and dressing to prevent a reoccurrence of the fall. Peoples records showed that GPs and other health professionals had been requested. A survey completed by a health professional received after the visit did not raise any concerns about the home. The manager said the provision of activities had been affected when the activities person had left their employment. However, he said a new activities person would be starting working at the home in the near future and activities would be resumed. Some medication records and medications in stock were checked and generally the records had been well maintained and when medication ahd been given it had ben signed for by staff. A comment received after the visit stated, Always get their medication on time. Some areas for improvement were noted: Kirkgate Unit: There was no analgesia in stock for a person. The wrong code was used when analgesia prescribed as one or two daily had not been given. On the nursing unit: Eye drops prescribed to be instilled four times a day had only been signed as instilled in the morning. The amount of analgesia carried forward on the medication records had not been recorded so an accurate audit could not be completed. This had been noted at the previous visit. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 12 The method of using divider cards between the medication blister packs was discussed with the manager and operations manager as it was seen that some dividers could adhere together leading to the wrong medication being given. An incident had occurred at the home since the last visit involving a person being given the wrong medication due to a divider being missing. Comments made by people living at the home included its very good here, its alright here no complaints. A visitor said they were very satisfied with the care and the home are meeting their relatives needs. Two surveys were received from relatives, one from a person living at the home and one from a health professional. Their comments were generally good and included very well looked after and the staff are always on hand for any emergency however small. However, a person considered that some staff did not have a good attitude. During the visit most staff were observed treating people respectfully and appropriately. A carer however was heard to refer to people who needed assistance to eat their meals as feeders; a nurse had also recorded in a persons care plan that they were a feeder. A carer was observed leaving one persons bedroom carrying a plastic bag containing a continence pad, which was covered in faeces and would be obvious to anyone in the hallways at the time. A persons professional title was not used when being addressed by staff even though the persons preference was written in their care plan. The manager said he would discuss these issues with staff to ensure they do not reoccur Snapethorpe Hall DS0000006209.V373373.R01.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The current provision of activities does not always ensure peoples social and recreational needs are fully met. The provision of meals are generally good however, the staffing arrangements at meal times do not ensure all people are receiving a nutritious, well balanced diet. EVIDENCE: The manager said there had not been many activities recently as the activities organiser had left, the Commission has been notified since the visit that this has occurred. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 14 Information provided by the service since the visit states that every two weeks a party is arranged of the first floor of the home and plants have been purchased to bring some greenery to the unit. Visitors seen during the visit made some positive comments about the care provided at the home, a visitor said they visited eveyday and staff made them feel welcome. The home operates a four - week menu and a choice of meal is available. The operations manager said a nutritional assessment is completed when new menus are introduced to ensure adequate nutritious diets are provided for everyone. A special diet had not been provided to ensure a persons religious beliefs were respected. Minutes of meetings showed that people who live at the home are given the opportunity to discuss the meals provided. People in the dining rooms on the ground floor were assisted appropriately and respectfully, people were relaxed and were observed talking to each other at the dining tables during the meal. A persons weight loss had been referred appropriately to their GP. People on the first floor unit had been given supplement nutritional drinks with their meal. Large quantities of supplement drinks prescribed by GPs were stored in the medication room. There was no organisation at lunchtime and it was considered that there was not enough staff on duty on this unit to ensure people were assisted appropriately as a resuot that meal times became a negative experience and there was risk of food intake not being monitored. A persons meal had been mixed together on their dinner plate and did not look appetising. Some people were seen with their meal untouched and were not being assisted. This was discussed fully with the operations manager and manager of the home who said they would be arranging for meals to be served at two sittings in the future to help with this. Snapethorpe Hall DS0000006209.V373373.R01.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Safeguarding referrals are made appropriately. However, people could be at risk when not appropriately supervised. EVIDENCE: Two complaints made to the home had been investigated and the outcomes had been recorded. It was recommended that the manager confirm with complainants if they are satisfied with the outcomes of their complaints. A survey received stated, We have not had any occasion to complain. Since the last visit nine safeguarding incidents involving people against people and one involving two staff against a person living at the home had occurred and appropriate action had been taken. During this visit staff did not respond promptly to a situation which occurred in a lounge when a person was displaying behaviour which could have affected everyone in the room and potentially led to a further safeguarding incident occurring. The manager said 85 of staff have now completed the in house safeguarding training course. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally the home is well decorated and maintained however, some areas need to be improved on to ensure a safe, pleasant environment is provided throughout the building. EVIDENCE: Whe walking round the building the inspectors observed that it was generally cleaned and decorated to a good standard. However, some redecoration was needed on the first floor mostly due to wheelchair damage to doors and walls. The manager said a rolling programme for re decoration is in place. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 17 The manager said signage for doors on this floor has been ordered and will be colour coded to help people find their way around the home. Seating areas for people who wander had been created at the end of the hallways to provide an envionment for people to sit and relax in. Peoples bedrooms visited were clean and tidy and personalised with photographs and pictures taken in their on admission to the home. The waste bins in toilets and bathrooms were not foot operated needed to reduce the risk of cross infection occurring. The manager said he would ensure these were provided. The carpet in the smoking room had burn marks and the registered person needs to seek the advice of the fire officer regarding a suitable replacement to prevent the risk of fire occurring. An unpleasant odour of urine was noted on the first floor of the home. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff recruitment procedures ensure peoples at the home are safe however, the staffing levels do not always ensure peoples needs would be met. EVIDENCE: There are not enough staff working on the first floor unit to ensure people are appropriately supported. At meal times some people were not being assisted to eat their meal, as staff were busy. Two staff spoken with said staffing levels are affected when staff are sick. One survey received stated, Staff are always cheerful and hardworking, perhaps a few extra would help. The night staffing levels on all units and the day staffing levels on the first floor unit need to be increased to ensure peoples needs are fully met and they are safe. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 19 Information provided by the service after the visit stated that 56.25 of staff had achieved NVQ qualifications. Staff files seen showed that inductions had been completed over a couple of days only which does not ensure staff will have the skills and knowledge to meet peoples need appropriately. References, and Criminal Records Bureau (CRB) checks had been completed prior to people starting work at the home to ensure vulnrable people in the home people are safe. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is appropriately supervised and working to ensure a quality care service is maintained. EVIDENCE: The manager said he is a registered nurse and is currently doing NVQ level 4 training, he said he has a diploma in Asthma, COPD and Warwick certificate in diabetes. He has been in post since 21 April 2008 and is currently waiting to be registered with the Commission for Social Care and Inspection. He said the companys operations manager and fellow managers from the regional team support him. A survey received after the visit stated The management are Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 21 always available to talk to us when we want to ask about our relatives problems. Some records for peoples monies held by the home were seen, all transactions are done electronically and banked in individual interest bearing accounts. This ensures that personal finances are managed o the maximun benefit of people who live at the home. Some records showed that staff meetings and meetings held with people who live at the home had occurred and had provided the opportunity for staff and people “to air their views” and contribute to the running home the home. Information provided by the service after the visit stated that staff supervisions and training have improved over the past twelve months. Some peoples records seen were not always up to date, care plans had been re written and not removed from the files, this could lead to staff accessing inaccurate information and peoples needs not met appropriately. Information provided by the service since the visit shows that system checks are completed and all staff have mandatory training, 75 of staff have had infection control training. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 2 10 1 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X X X 2 STAFFING Standard No Score 27 1 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 x 3 3 2 3 Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15(1) 13(4)(c) Requirement Timescale for action 22/12/08 2 OP10 12(4) 3 OP15 16(2) 4 OP18 12(1) 5 OP19 23(2) Care plans and risk assessments must include all assessed needs, and the action to be taken by staff to ensure needs are appropriately met and people are safe. Staff should speak to people 22/12/08 respectfully at all times and assist them in a manner, which respects their rights, their privacy, and dignity. Staff should assist people who 22/12/08 are unable to eat their meals so that they receive a nutritious diet at all times. Meals should be provided that ensure peoples religious beliefs are respected. Incidents that occur when people 22/12/08 demonstrate extreme behaviour must be better managed by staff to ensure people are protected • The areas identified during the visit should be redecorated in order to further improve the environment in which people live. Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 24 23(4)(a) • • The carpet in the smoking room should be replaced with a floor covering that is fire retardant to prevent 22/12/08 the risk of fire occurring. People should be appropriately supervised in the smoking room to prevent the risk of fire occurring. 31/01/09 6. OP26 16(2)(k) The waste bins in the communal toilets and bathrooms should be foot operated to prevent the risk of cross infections occurring. All rooms and hallways on the first floor must be kept free of unpleasant odours of urine so that a pleasant environment is provided for all people to live in. The registered person must keep the staffing levels under review to ensure that there are enough staff on duty at all times of the day and night to meet peoples needs and keep them safe. 12(1) 7. OP28 18(1) 22/12/08 Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 25 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 OP3 Good Practice Recommendations Information obtained at the time of pre admission assessment should be recorded fully, signed and dated to confirm agreement and accuracy of the information. Eye drops should be instilled as prescribed by the GP to ensure treatment is effective. Balances of medications should be carried forward on the medication records to provide an accurate audit trail. Staff should check to ensure the dividers on the medication blister packs do not adhere together to prevent the wrong medication being given to people. Analgesia should be available in stock when needed to ensure people are comfortable. Activities should be provided which meet peoples needs choices, preferences and abilities. People should be asked if they are satisfied with the outcome of complaints made to the home and a record of their response kept. Staff inductions should be completed over the duration of their probationary period to ensure they had the knowledge and skills needed to meet peoples needs. Peoples records should only contain up to date information in respect of them and their needs to ensure accurate information is held in respect of them. 2. OP9 3. 4. 5. 6. OP12 OP16 OP30 OP37 Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 26 Care Quality Commission Yorkshire & Humberside Region Citygate Gallowgate Tyne & Wear NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.yorkshirehumberside@cqc.org.uk Web: www.cqc.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 Snapethorpe Hall DS0000006209.V373373.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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