Inspection on 13/07/05 for St Giles Private Nursing Home

This inspection was carried out on 13th July 2005.

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

St Giles Private Nursing Home 25/04/08

St Giles Private Nursing Home 06/09/06

St Giles Private Nursing Home 27/01/06

St Giles Private Nursing Home 08/02/05

St Giles Private Nursing Home 16/07/04

St Giles Private Nursing Home 16/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE St Giles Tile Cross Road Garretts Green Birmingham B33 0LT Lead Inspector Amanda Lyndon Unannounced 13 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Giles Address Tile Cross Road Garretts Green Birmingham B33 0LT 0121 770 8531 0121 770 8146 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) St Giles Care Ltd Vacant Care Home with Nursing 48 Category(ies) of Older People (48) registration, with number of places St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home is registered to accommodate 48 adults over the age of 65 who are in need of nursing care for reasons of old age and will include one named individual, who is 48 years of age and is in need of nursing care whilst alternative private housing is arranged. 2. One named individual who was 48 years of age at time of admission and in need of nursing care can be accommodated and cared for. 3. Up to five service users between the ages of 55 and 65 years who are in need of nursing care can also be accommodated and care for in this home. Date of last inspection 8 February 2005 Brief Description of the Service: St Giles is registered for 48 older people, who require nursing care. The home is also registered to accomodate up to five people between the ages of 55-65 who are in need of nursing care. St Giles is situated in Garrets Green, close to public transport links and has facility for off road parking. The home is purpose built and the accomodation is spread over two floors. All bathrooms are on suite with toilet and washbasin. Bathing facilities are shared,with a mixture of assisted baths and floor draining showers on both floors of the building. Dining facilities and lounges are communal and the home aslo has a hairdressing salon. Kitchen and laundry facilities are based on site. The home is a non smoking environment and a shelter is provided outside for this purpose. St Giles employs an activities co ordinator and a wide range of activities are on offer. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was undertaken by three inspectors, including the pharmacy inspector, during a morning/afternoon and were assisted throughout by the Manager. There were 46 residents living at the home on the day of inspection. Information was gathered from talking with the residents and staff and from observing the care staff performing their duties and examining care and medication records. What the service does well: What has improved since the last inspection? What they could do better: Continued liaison with the community pharmacy must occur to rectify supply problems encountered by the home to ensure the service users needs are met and they receive the medication as prescribed. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 6 Some care plans require further development to identify specific requirements, particularly for behaviour techniques and management. Resident meetings should be held in order for residents and relatives to discuss ideas and concerns. Prior to residents coming to live at the home, assessment needs should be checked to ensure that the home is appropriate not only in its ability to provide the care but also that it is acting within its conditions of registration and there are no conflicting needs of existing residents. 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. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 & 3 The admission and assessment processes and information available for prospective residents is comprehensive, with the exception of a recent admission. The home were unable to meet fully the care needs of one resident living at the home and this has had a negative impact on and possible risk to the safety of both the individual and other residents living at the home. EVIDENCE: The statement of purpose requires minor adjustments to ensure it includes all the information required by Schedule 1 of the Regulations. The home has produced a service user guide which is available in an appropriate format for service users. Service users are issued with a contract of terms and conditions of residency. Pre admission assessments are undertaken by the home manager for all prospective service users, however the documentation requires amendments to ensure that all of the information required by standard 3 of the National Minimum Standards is covered. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 & 9 Residents health and personal care needs were generally well met by the care staff. Care plans were comprehensive, with the exception of a recent admission, where there was no documentary evidence, which may result in this resident not receiving good continuity of care. Medicines are generally safely managed but more attention to detail is needed in some aspects and records. The nursing staff demonstrated good clinical knowledge of the residents. EVIDENCE: In general, there have been improvements since the last inspection in relation to care planning. Two residents care plans were sampled by the inspectors, one of these was found to be very comprehensive in detail. The other care file, a recent admission (two weeks ago) did not have any care plans in place, and the admission form had not been fully completed, therefore there was no instruction for care staff to follow. A falls risk assessment, bed rail safety risk assessment and a manual handling assessment had been completed but no further guidance had been written on the outcome of the assessment. A continence assessment had not been completed. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 10 Each resident had a separate set of care plans, however they required further development to include details of actions to be taken by care staff to ensure that all aspects of health, personal and social care needs of individual residents are met. Some care plans identified specific equipment/aids to be used and were evaluated monthly. It is recommended that residents or their relatives also sign the care plans as proof that they agree with the plan of care. Some care plans were personalised and included specific preferences such as “does not like perfume” and “likes to have the bedside lamp on at night”. Falls risk assessments require further information on what to do should a resident fall. A recent admission, to the home, had not yet got an activities plan devised. Another file sampled had an activity plan which stated that the resident was “unable to do activities” however the inspector had a lucid conversation with the resident and the manager stated that she enjoys quizzes and entertainment. This information must be reflected in the care plan. Waterlow scores were reviewed monthly as were the majority of risk assessments. Monthly weights were recorded and there is space to record weight loss or gain. The manager is waiting for some guidance, from the dietician on a different nutritional scoring tool from the one currently used. Daily reports described how residents spent their day, however some entries were found to be non descriptive and did not always include information about activities the resident had engaged in, for example, comments made were “comfortable day” and “Uncomplaining”. Monitoring of residents behaviour, and visits from the doctor had been recorded in the daily reports, rather than using behaviour charts and the G.P visit chart. Separate entries would help with the monitoring of healthcare needs. There was evidence that residents are seen by other healthcare professionals such as physio, dietician, optician, Community psychiatric nurse and general practitioner. Good practice for medicine management found on the ground floor was not echoed throughout the home due to problems encountered with the supply from the community pharmacist. Nursing staff failed to record the balances of medicines carried over from previous Medicine Administration Record (MAR) charts, therefore audits to demonstrate whether medicines had been administered as prescribed could not be undertaken accurately. One transcribing error was found. The hand written MAR chart directions were not what the doctor had prescribed. One service user did not receive his pain relieving medication as only one nurse was on duty one night and a second nurse was not present to witness the Controlled Drug administration. The nurse failed to adhere to the policies and procedures within the home, which would have prevented this. The community pharmacist had not delivered some St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 11 medicines on time resulting in service users not receiving the prescribed medication until the supply was received. Nursing staff could not evidence that medicines administered via a PEG tube were suitable for this route of administration. Medicines were stored in designated lockable refrigerators but the temperature for both were too high. No action had been taken. The medicines stability could not be guaranteed. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14 & 15 Residents are able to exercise their choice over their daily lives and the activities that they choose to participate in which promotes their individuality and independence. Residents interests are not always accurately recorded in a plan of care. Residents receive a wholesome and varied diet however liquidised food is not of a suitable texture to ensure the safety of residents who require this specific diet. EVIDENCE: The home has an open visiting policy and relatives were seen to visit throughout the inspection. One resident had chosen to eat her lunch outside with the assistance of her visitor. Residents were relaxed and some were enjoying chatting with other residents. Dining tables were laid attractively with appropriate utensils and the layout assisted with social interaction. Residents had the choice of roast pork or cheese salad, the displayed menu downstairs identified the choices, however the displayed menu upstairs had not been changed and did not reflect the choices on offer for that day. Cold drinks were served prior to the meal. Meals were fully served to the residents and staff were observed to assist the residents appropriately. Residents were wearing plastic aprons to protect their St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 13 clothing, however a more suitable alternative should be sought to promote their dignity. The CSCI had received a complaint regarding the food not being liquidised adequately, and this is unresolved. The inspectors looked at the meals and found that the pureed meals do have portions served separately in keeping with good practice, however the soft diet did have pieces of chewy pork and rind in, which anyone requiring such a diet would not have been able to eat, however this had not been served to service users for this reason. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The complaints procedure is comprehensive and is accessible to the residents and visitors should they need to make a complaint. EVIDENCE: The CSCI has received two complaints since the last inspection. The elements of the first complaint have not been upheld and the second complaint is currently being investigated by the Registered Provider and the home manager, following the homes complaint procedure. A full complaints log record is kept by the home and there are no further complaints recorded that the CSCI are not aware of. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 & 26 The overall quality of the furniture, fixtures and fittings are of a high standard and St Giles provides a homely, clean, safe environment to live, where residents feel relaxed and secure. EVIDENCE: St Giles is very homely in style and found to clean and odour free. Furniture, fixtures and fittings are all of a high standard. There is adequate seating within the home and this is arranged to promote social interaction. Residents were observed to be seated in the communal lounges, whilst some had chosen to stay in their rooms and others had gone into the garden. There are three assisted baths and 4 shower facilities at St Giles. Raised toilet seats are available as required and there are grab rails provided near to both sides of the toilet. Emergency call bells are available in all bedrooms, however one residents bed had been moved away from the call point and the overhead St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 16 light so that care staff could manoeuvre more easily. It was not documented why the bed had been moved or why the resident would not be able to use the call bell. Bed rails and protectors were in use and risk assessments had been completed in respect of this. Relevant pressure relieving equipment was seen in use on beds. It was noted that a rolled up quilt was used as a pillow on one bed and the one pillow in use was flat. The manager was advised to check pillows, removing any which were no longer fit for purpose, and replace with new ones. Staff should utilise the equipment they are provided with such as backrests which are fitted to the bed. On the day of the inspection all areas of the home was found to be very warm. Some fans were in place however thermometers were still recording temperatures of 81-82 degrees Fahrenheit. The Home Manager stated that she would obtain additional means of cooling, to ensure the environment is as comfortable as possible. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 The home has maintained an established team of staff, since the last inspection providing an appropriate skill mix and allocated numbers of staff over the full day and night to offer good consistent standards of care to meet the assessed needs of the residents. Recruitment procedures require further improvements to ensure the safety of the residents. Staff receive a comprehensive induction programme and this ensures they have a basic knowledge of working within their roles after commencing employment at the home. EVIDENCE: No members of staff have left since the last inspection in February and there are currently no vacancies. The manager is supernumery to staff and if working as the “nurse in charge” this is clearly identified on the off duty rota. Sickness and Absence is also clearly noted on the duty rota, and the manager stated that “sickness has improved” Off duty rotas were checked and provided evidence that there were adequate numbers of staff on duty. A staff file was sampled and this showed evidence of POVA check and request for criminal records bureau check. Amendments to the recruitment process are required in respect of references, as the last employer reference had not been sought. There was written evidence of two verbal references although these had not been backed up in writing, and did not state in what capacity the St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 18 referee knew the prospective employee. Reasons for leaving employment had not been written on the application form and no interview notes had been made , therefore there was no evidence that this had been explored. There was evidence that a full induction had been completed and food hygiene training had taken place. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,35,37 & 38 The Manager has previous managerial experience and has much experience of working with older people, and is striving to ensure that a good standard of care is provided at the home, however she must formally complete the managers registration process. The home had failed to inform CSCI of some incidents regarding the health, safety and welfare of some residents. EVIDENCE: The manager is yet to complete her application for the Registered Managers post at St Giles, and has yet to commence the Registered Managers Award, however has made enquiries into the course and is waiting a reply. The manager has recently completed training to become a moving and handling trainer, and states that “all the staff are up to date”. Visits to St Giles are made by the Provider and director, however the regulation 26 reports are not sent to the CSCI as required. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 20 No residents meetings have taken place since the last inspection, and this must be addressed to ensure that residents and their families are given the opportunity to discuss and share any ideas or concerns about the home in an open and inclusive atmosphere. All personal allowances are stored separately and there is a separate transaction record for each. It is recommended that receipts are numbered for ease of auditing and that two signatures are provided for all transactions. There was no written evidence that auditing takes place. Three account balances were checked by the inspector, two of which were correct, the remaining one had extra money in the envelope to what was recorded on the form. Maintenance personnel carried out a fire test on the alarm panel whilst the inspectors were present. Accident forms are completed and there is evidence of monthly accident auditing, however the home has failed to inform the CSCI of some accidents and unexplained injuries as required by Regulation 37. Tipex correction fluid was noted on a accident report and also on one of the residents personal allowance sheets. St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 2 x x x 2 x 2 2 St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Schedule 1 * The actual sizes of the bedrooms need to be included *Any procedures for emergency admissions. * The service user guide must include service users views of the home. (Previous time scale of 08/07/05 not met) Following this inspection, CSCI were informed that the above requirement has been met. 14/07/05 A urgent review must be arranged for a named resident currently living at the home. Care plans including behaviour management and risk assessments must be completed. The manager received this as an immediate requirement. The care planning system must be further developed to include: Regulation 4(1)(a)(b) (c) 5 (1) Requirement The statement of purpose requires minor adjustments to include the following: Timescale for action 13/11/05 2. OP4 12(1) 3. St Giles OP7 15(1)(2) 30/09/05 Page 23 E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 * Care plans for specific acute medical conditions must be written and care plans must include more detail of how care needs are met. * A record of visits from healthcare professionals must be kept and written evidence that the nursing staff had followed their advice and monitored specific physical and health needs must be maintained. (Previous time scale of 18/05/05 not met) Care plans for behaviour must be written, including detail of management techniques. 4. 9.1 13(2) The nursing staff must adhere to the policies and procedures for medicine management at all times to ensure the service users needs are met The quantities of all medicines received or balances carried over from previous cycles must be recorded to enable audits to be undertaken to demonstrate whether medicines are administered as prescribed and also staff competence in medicine management All medication must be administered as prescribed at all times. Liason with the community pharmacy must take place to rectify the problems encountered within the home due to incomplete supply and failure to print the MAR charts for all One day and ongoing One day and ongoing 5. 9.3 13(2) 6. 7. 9.4 9.4 13(2) 13(2) One hour and ongoing One week and ongoing St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 24 service users 8. 9.4 13(2) The medication refrigerator temperatures (maximum, minimum and current) must be read daily. These must lie between 2°C and 8°C at all times to ensure the medicines are stored within their product licences. The thermometer must be zeroed following each recorded reading. The homely remedy policy must be further developed to include detail of the medication issued by the nursing staff with the General Practitioners consent. (Previous time scale of 08/06/05 not met) The home must record evidence of the authenticity of references obtained in respect of propective staff members and a record of this must be kept on each staff file. One day and ongoing 9. OP9 13(2) 17 1/10/05 10. OP29 19(1)(c ) 31/08/05 11. OP29 (Previous time scale of 08/05/05 not met) 19(1)(b)(c References must be sought from ) prospective employees most recent employer and verbal references must be confirmed by written references. The manager received this as an immediate requirement. 24(1)(a)(c Service user meetings must be ) arranged more frequently. (Previous time scale of 08/07/05 not met) The registered provider must supply a copy of the written report of the findings of their visit to CSCI monthly as required by Regulation 26 13/07/05 and ongoing 12. OP32 15/09/05 13. OP32 26 30/09/05 St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 25 14. OP38 13(6) 37 (Previous timescale 0f 08/05/05 not met) Appropriate action must be taken following any unexplained bruising, including referral to social services,G .P, family and CSCI. Incident forms and regulation 37 forms must be completed and sent to the relevant parties. The manager received this as an immediate requirement. The manager must formally complete the application for the managers registration process. 13/07/05 15. 16. 17. 18. 19. 20. 21. 22. 23. OP31 9 31/08/05 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 OP7 Good Practice Recommendations It is recommended that as well as signing consent to treatment forms, resident or representative should also sign each care plan as proof of agreeing to individual care plans. It is recommended that the action to be taken should a service user fall be included in the moving and handling risk assessment Advice must be sought to confirm the suitability of all medicines administered via a PEG tube. It is recommended that a more suitable alternative to plastic aprons, for resident meal times is sought, in order to maintain dignity. E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 26 2. 3. 4. OP7 9.4 OP10 St Giles 5. 6. 7. 8. 9. 10. OP26 OP29 OP31 OP37 OP15 OP3 11. 12. OP37 OP25 It is recommended that infection control audits are undertaken regularly It is recommended that interview notes are written in order to evidence any questions asked at interview. The home manager must complete the Registered managers award or equivalent during 2005. It is recommended that the missing persons policy be further developed to include the actions for staff to follow when the service user returns or is found. Menus on display should be an accurate reflection of the choice of meal on offer. The pre admission assessment document template should be further developed to include all of the information required by Standard 3 of the National Minimum Standards. Records should not be corrected with tipex or other such preparation. Additional means of cooling the environment should be sought to reduce the temperature of 82 degrees Farenheit in communal and bedroom areas of the home. The home should provide pillows that are fit for purpose and staff should utilise the appropriate equipment available to assist service users to be in an upright position whilst in bed. 13. OP24 St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 Page 27 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4 UZ 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 St Giles E54 S24893.St Giles.V239640.120705 - Stage 2.doc Version 1.40 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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