Inspection on 04/09/07 for St Marks Care Home Limited

This inspection was carried out on 4th September 2007.

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 Marks Care Home Limited 16/09/09

St Marks Care Home Limited 17/09/08

St Marks Care Home Limited 11/09/06

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE St Marks Care Home Limited 38-40 Wellesley Road Clacton on Sea Essex CO15 3PW Lead Inspector Francesca Halliday Key Unannounced Inspection 09:30 4 – 18 September 2007 th th 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 St Marks Care Home Limited DS0000066522.V350214.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. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Marks Care Home Limited Address 38-40 Wellesley Road Clacton on Sea Essex CO15 3PW 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) 01255 421750 01255 435282 sandy@sahadew.fsnet.co.uk St Marks Care Home Limited Manager post vacant Care Home 17 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (17) of places St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 17 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 17 persons) The total number of service users accommodated in the home must not exceed 17 persons 11th September 2006 Date of last inspection Brief Description of the Service: St Marks Care Home can provide personal care and dementia care for up to 17 people over the age of 65 years. The home has been converted from two private residences. It is on a residential street in Clacton-on-Sea close to the town centre and sea front. Accommodation is provided on two floors, with the upper floor being accessed by a passenger lift. Thirteen rooms are single occupancy and two rooms are shared. Residents have a dining area and two sitting rooms available to them. There is a small garden to the rear of the property and limited off road parking in front of the home. The home had a range of information for prospective residents and their representatives. At the time of inspection, in September 2007, the fees were £374 - £420. Additional charges were made for toiletries, hairdressing, private chiropody and privately arranged activities. More up to date information on fees can be obtained directly from the home. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place on 4th September 2007. Throughout this report the term resident is used to refer to people who live in the home. Four staff including one of the proprietors were spoken with during the inspection. Seven residents were spoken with during the inspection, although communication with some residents was limited due to the degree of their dementia. Seven surveys were received from relatives and six from staff and two relatives were spoken with following the inspection (a number of residents had completed surveys but they had not been received by the time the inspection report was completed). Parts of the premises and a sample of records were inspected. Further information was requested at the time of inspection, which arrived on 18th September 2007, and this concluded the inspection process. What the service does well: What has improved since the last inspection? What they could do better: The home had been without a manager since June 2006 and this had impacted on standards in the home. Some relatives considered that the home did not always have sufficient staffing levels to provide appropriate care and supervision for residents with very diverse needs. Comments from some relatives indicated that communication and response to concerns could be St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 6 improved. These perceptions may have resulted in part from the lack of management and supervision of staff. Care documentation needed to be more person centred and some improvements were needed in medicines management. The proprietor was aware that the standard of catering needed to be improved and was hoping to recruit a new chef who could prepare more home cooked meals. New staff were not receiving a sufficiently thorough induction prior to working on their own and some training needs were identified. Some staff were more task orientated than others and did not promote residents’ choices and independence. Staff did not always treat residents in a manner that respected their dignity. Residents said that there was limited social stimulation and activities in the home and a number of relatives also considered that this was an area that needed to be developed. Following the inspection full time supernumerary management cover for the home was put in place. One of the proprietors was covering three days a week and a senior carer was covering two days a week. The proprietor confirmed that prompt action was being taken to address all the issues raised in this report. 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. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Quality in this outcome area is adequate. Prospective residents receive an adequate assessment of needs prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Potential residents received a visit and had a preadmission assessment carried out by the proprietor or senior care staff. The assessments seen were of variable quality and some had not been dated or signed. The assessment form needed to be developed in order to record the abilities, interests, expectations and preferences of prospective residents so that there would be no mismatch between expectations and the services and care provided. The form also needed to be expanded in order to gain more detailed information about the mental health status of prospective residents with dementia, in order that the home could accurately assess whether they could meet the prospective resident’s needs. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10. Quality in this outcome area is adequate. Residents do not always receive person centred care. Medicines management does not always protect residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents spoken with and relatives surveyed were generally happy with the standard of care in the home. Although three relatives considered that staff sometimes found it difficult to meet the sometimes conflicting needs of residents with and residents without dementia. Senior staff spoken with generally had a good understanding of individual resident’s needs. However, this was not reflected in the care documentation seen. Of the four records sampled, three did not contain any care plans and the fourth had very limited care plans that did not cover all the identified needs and problems of the resident concerned. A discussion was held about the need to make the care documentation more person centred and to expand it to cover residents’ abilities, interests and preferences with details of how staff could assist them to maintain their life skills. Five residents had developed pressure sores in the St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 10 past year but staff had not received any training in the prevention and management of pressure sores. Four staff had received training in falls prevention and there was evidence that a resident had been appropriately referred to the falls prevention service. Three staff had received training in continence care, three in the prevention of constipation and three in diabetes. The care documentation contained a range of risk assessments. However, some of the assessments were not dated and signed and some did not reflect residents’ current health status. Although it was evident from discussion with staff that they were monitoring residents’ psychological and physical health, there was limited confirmation of this in the care documentation. Following the inspection the proprietor confirmed that full time management cover was put in place and that all the care documentation would be fully updated in consultation with residents (and relatives where appropriate). Staff considered that GP support was generally good and residents reported that they could see the GP when they had a health concern. A chiropodist visited the home on a regular basis and there were systems in place for residents to have optical and dental checkups. There was evidence that residents were referred to local health services for appointments and treatment when necessary. The majority of relatives surveyed considered that staff usually kept them informed of any health concerns. However, one relative considered that communication with them had recently deteriorated and gave a number of examples when communication had fallen down. A discussion was held with the proprietor about the fact that the lack of manager in the home for over a year may have contributed to the problems with communication. Medicines management needed some improvements. The Controlled Drugs (CD) register was not being completed correctly and there were also a few gaps in staff signatures following administration. The balance of one CD was not correct. A member of staff was reminded not to leave the medicines trolley unlocked and unsupervised when administering medicines. Staff were not recording the date of opening on medicines with a limited shelf life on opening. Some of the Medicine Administration Records (MAR) needed to be clearer; it was not always possible to establish whether medicines had been discontinued, the reason that medicines had not been given as prescribed and the actual dose given when variable doses had been prescribed. Changes to the MAR did not always clearly identify who was making the change on the MAR and the GP authorising it. Some medicines for one resident were not available for 3 and 4 days. A new medicine cupboard had been built since the last inspection and storage temperatures were being monitored. Staff had a range of information available on medicines for reference. Photographs were available in the MAR folder for ease of identification of residents. The proprietor confirmed that regular medicines audits would be carried out and any issues promptly addressed. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 11 Residents spoken with said that staff usually treated them with respect and respected their privacy. However, a member of staff was overheard speaking very sharply to a resident in a way that did not uphold their dignity. A relative said that the resident they visited had been “made to feel unreasonable, or even a bit “dotty” when requesting something”. Two relatives considered that some staff should “give more respect” and not “talk down” to residents. The proprietor said that these issues would be regularly discussed at staff meetings. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15. Quality in this outcome area is adequate. Social stimulation offered by the home is not sufficient to give a good life style for residents and to maximise their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was evidence that the home offered some social stimulation, activities and trips out, but that this did not occur on a daily basis. A fortnightly session of movement to music was held. One resident described how she enjoyed assisting with the drying up. The proprietors had made alterations to the kitchen so that there was an area where residents could assist in the kitchen safely away from the main preparation and cooking area. However, a number of relatives considered that residents needed more stimulation. One relative considered that the home needed “more in-house activity for residents who are more active and external visits and trips”. A number of staff surveyed and spoken with considered that they did not have sufficient time to sit with residents and provide regular stimulation and activities. The records seen provided very little evidence of meaningful activities with statements such as “sitting in the lounge” recorded. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 13 Relatives said that they were generally made to feel very welcome when they visited the home. The home had some links to the local community but this was an area that could be developed. Staff spoken with on the day of inspection gave examples of how they had assisted residents to maintain independence and make choices in the home, and there was some documentary evidence of this. However, one relative said that some staff did not support residents to live the life they chose and said that the resident they visited found it “sometimes difficult to lie/stay in bed if she is feeling under the weather”. Staff spoken with about this agreed some staff were less flexible than others in responding to individual needs and wishes. Residents spoken with at the time of inspection were generally happy with the food. Choices were not offered but residents confirmed that alternatives would be provided if they did not like what was on the menu. However, one resident said “It’s not like you have at home” and another said “I’ve known better”. A number of relatives and a few of the staff considered that the standard of food in the home needed to be improved and that there was too much reliance on convenience foods. One relative surveyed stated “It’s a pity with such a nice kitchen that the food is not better! Greater efforts could be made rather than cheap, cheap, cheap”. Another said “the diet could be improved”. The proprietor said that the current chef was leaving shortly and they were hoping to employ a chef who would provide more home cooked meals from fresh ingredients. The new cook would also start at 08:00 instead of 09:00 in order to assist with breakfasts. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16, 18. Quality in this outcome area is adequate. Residents are not always treated as an individual and cannot always be confident that their concerns are appropriately addressed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One relative said “comments and suggestions are listened to and acted upon if needed to be”. Another relative considered that staff initially responded well to concerns, “but recently not. There is usually an explanation, which isn’t very satisfactory and the concern remains unattended”. Another relative said that they did not like to complain, as they were concerned about possible “repercussions”. Staff were not recording verbal concerns and complaints or the action taken to resolve issues raised. The lack of manager, and lack of feedback from staff on residents’ and relatives’ concerns, may have contributed to their perception that concerns were not always addressed. A number of staff had not received safeguarding adults training at the time of inspection, however, six staff received training following the inspection. Some staff spoken with had a good understanding of the different types of abuse and the actions to take if abuse was suspected. The task orientated care provided by some staff demonstrated a lack of awareness of institutional abuse. The proprietor said that discussions about institutional abuse would be held during staff meetings. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 26. Quality in this outcome area is good. Residents generally live in a clean and fresh environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A number of areas of the home had been refurbished and new furniture purchased. Three bedrooms had new en-suite facilities installed and a bathroom had been considerably improved and an assisted shower installed. One shared room had been converted to two singles. An upgrade in the kitchen was in the process of being undertaken and the proprietor was aware that fly screens would need to be installed once the building work was complete. A new staff room had been created. The garden was in need of some attention to create a pleasanter outlook for residents. The owners were aware that the exterior of the home needed to be repainted. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 16 Residents and relatives considered that the home was generally kept very clean. One relative described the home as “always fresh and clean”. A discussion was held with the proprietor about improving the cleanliness in one resident’s room and in the laundry, and she said that this would be addressed following the inspection. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29, 30. Quality in this outcome area is adequate. Residents do not always receive person centred care. Sound recruitment procedures provide protection for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: For the past year the home had not had a manager and this had impacted on overall staffing levels and supervision of staff. One resident said that staff were “too busy to come and talk to you”. Some relatives said that a few staff became annoyed if individual residents took up too much of their time. One relative said that a member of staff had apologised to them and told them that staff should not have told them they were too busy to provide the care required. Some staff surveyed and spoken with said that they did not have time to do all that was required or time to sit and chat to residents and admitted that care was at times task oriented. During the inspection the residents in both lounges were noted to be without staff supervision for long periods of time. Four staff had completed National Vocational Qualification (NVQ) at level 2. At the time of inspection the home did not meet the standard for 50 of care staff to have an NVQ at level 2 or above. However, the home was actively working towards the standard with one member of staff undertaking NVQ level 2 and five members of staff undertaking NVQ level 3. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 18 A sample of staff records was inspected and the required information had been obtained. There was evidence of Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) list checks and references for new staff on file. The proprietor confirmed that work permits and visas were checked when appropriate. There was evidence that new staff, without caring experience, were not receiving an appropriate induction with sufficient supernumerary time to enable them to be directly supervised. Some staff surveyed considered that new staff needed more training before they carried out specific tasks on their own. Some relatives considered that a number of new staff needed more training. One relative considered that there were “new people working at St Marks who I believe do not have the experience of skilled carers” and that the home had admitted new residents who “need a lot more care and attention, but not provided sufficient staff with appropriate skills”. The proprietor confirmed that the home would be using the Skills for Care induction in conjunction with the relevant knowledge sets in future. A number of staff had not received any training in dementia care. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 38. Quality in this outcome area is adequate. The lack of manager has impacted on the quality of services and care to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had been without a manager since June 2006. The proprietors had provided some managerial support but this was limited as they both were registered managers of other homes. None of the staff had been given supernumerary time to enable them to cover the managerial role on a day-today basis. This had resulted in a lack of management and a lack of a quality assurance programme for monitoring of standards in the home. Following the inspection arrangements were made for one of the proprietors to provide St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 20 supernumerary cover for the home on three days and for one of the senior carers to provide supernumerary cover on another two days. The systems for managing the small amount of residents’ personal money were satisfactory. There were records and receipts for all transactions and balances checked were correct. The proprietor was appointee for one resident and there were clear records for all transactions. There was evidence from discussions with residents and relatives and observation during the inspection that staff were on occasions transferring and lifting residents with an underarm move. This type of move could be potentially hazardous to both residents and staff. There were good systems in place for maintenance and servicing of equipment. The proprietor said that the fire alarm system had been improved and confirmed that they would get the fire services’ advice on the changes made to the premises. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 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 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 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 X X 2 St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 22 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. The following requirements were discussed with the proprietor at the time of inspection. No. 1. Standard OP3 Regulation 14(1) Requirement The pre-admission assessments must be expanded to provide more information on prospective residents’ mental health status and to cover their abilities, interests and preferences in order that their expectations and needs can be fully explored prior to admission. Timescale for action 04/09/07 2. OP7 15(1)(2) 01/10/07 Care plans must be drawn up in consultation with residents (and relatives where appropriate) and demonstrate their preferences, abilities, interests as well as their physical and mental health and care needs in order to encourage more resident centred care. This has been a requirement in a previous report – timescale of 01/10/06 not met. Risk assessments must be kept up to date in order to accurately assess the current and ongoing risks to residents. DS0000066522.V350214.R01.S.doc 3. OP8 14(2) 04/09/07 St Marks Care Home Limited Version 5.2 Page 23 4. OP8 18(1) Staff must receive training in the prevention and management of pressure sores in order to improve the care to both residents at risk and those who have developed pressure sores. 01/12/07 5. OP9 13(2) Staff must ensure that all 04/09/07 medicines are accurately recorded in order to be able to check that residents have received all their prescribed medicines. The systems for ordering must be reviewed in order that residents do not have interruptions to the administration of their prescribed medicines. This has been a requirement in a previous report – timescale of 01/10/06 not met. Residents must be consistently treated in a way that respects their individuality and protects their dignity. 04/09/07 6. OP10 12(4) 7. OP12 16(2)(m) (n) 18(1)(c) Residents must receive sufficient 01/11/07 stimulating activities to enhance their daily lives. Staff must receive training in the provision of activities for older people to ensure they are skilled. This has been a requirement in a previous report – timescale of 01/10/06 not met. Residents must be encouraged to 04/09/07 retain their independence and supported to make choices in order to improve the quality of their daily lives. The menu must be reviewed in order that residents can be DS0000066522.V350214.R01.S.doc 8. OP14 12(2)(3) 9. OP15 12(1)(a) 01/10/07 Page 24 St Marks Care Home Limited Version 5.2 provided with a more balanced and nutritious diet. 10. OP16 22 Staff must feed back and document verbal complaints to ensure that residents’ and relatives’ concerns are fully addressed. Staff must have a sufficient understanding of the different forms of abuse in order for residents to be protected from potential institutional abuse. 04/09/07 11. OP18 13(6) 01/10/07 12. OP27 OP30 18(1) Staff must be deployed to 04/09/07 supervise residents when they are sitting in the lounges in order that they can meet residents’ social and care needs. Staff must receive an initial induction and sufficient supernumerary time to enable them to be competent in their practice prior to caring for residents on their own. All staff must receive dementia care training to enable them to care appropriately for residents with dementia. 01/12/07 13. OP30 18(1) 14. OP33 OP31 24(2) Full time managerial cover must 10/09/07 be provided for the home until the post of registered manager is filled, to enable standards of care and services for residents to be monitored and any deficiencies promptly addressed. Staff must only carry out moving and handling in a manner that does not put themselves or the residents at risk of injury. 04/09/07 15. OP38 13(5) St Marks Care Home Limited DS0000066522.V350214.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 OP13 Good Practice Recommendations Links to the community should be developed for the benefit of residents’ social life. St Marks Care Home Limited DS0000066522.V350214.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Marks Care Home Limited DS0000066522.V350214.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!