Inspection on 27/09/05 for Steepleton Manor

This inspection was carried out on 27th September 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 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

Steepleton Manor 19/02/07

Steepleton Manor 12/01/06

Steepleton Manor 16/03/05

Steepleton Manor 24/11/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Steepleton Manor Winterbourne Steepleton Dorchester Dorset DT2 9LG Lead Inspector Rosie Brown Announced 27 September 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. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Steepleton Manor Address Winterbourne Steepleton, Dorchester, Dorset, DT2 9LG 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) 01305 889316 01305 880165 Altogether Care LLP Mrs Elaine Pitney PC Care Home only 36 Category(ies) of OP - 36 registration, with number of places Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: A maximum of six double bedrooms to be used at any one time. The home can accommodate a maximum of two younger adults, in the category PD, in rooms for single occupancy only. Date of last inspection 16 March 2005 Brief Description of the Service: Steepleton Manor is a large Grade II listed late Victorian Manor House set in 6.5 acres of landscaped grounds, which include a Victorian walled garden. It is situated in the quiet rural location of Winterbourne Steepleton. The village church is nearby and Dorchester is approximately 4 miles away: a river runs alongside the property and provides the additional interest of abundant wildlife and birds. Steepleton Manor is registered to accommodate a maximum of 36 elderly people, in 24 single and 6 double bedrooms. With the exception of three single bedrooms (which have separate dedicated private bathrooms) all offer en-suite toilet facilities. A passenger lift enables access to the first and second floors of the home: at this level four bedrooms are accessed by a short additional flight of stairs. At first floor level a separate stair lift is fitted to a small staircase and provides assistance to negotiate the stairs. Other facilities include an outdoor heated swimming pool, which is used during the summer months. The Registered Individual (RI) is Mr Peter Cotterill on behalf of Altogether Care LLP and the Registered Manager is Mrs Elaine Pitney. The home was previously owned by Mr and Mrs Westlake who continue to be involved with the buisness and continue to be present in the home each week. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 27th September 2005 between the hours of 10:15am and 3:15pm. The purpose of the visit was to review the requirements and best practice recommendations set out in the previous inspection report. It was one of two statutory inspections planned for the year. This home was subject to two unannounced inspections the year before and the Registered persons had requested an announced inspection. Information was gathered through discussion with Elaine Pitney, the manager, Mr Peter Cotterill, two service users who had requested an interview with the inspector and the five of the staff on duty at the time. The inspector used observation skills to access some of the findings. The communal areas of the home were viewed and a selection of residents’ bedrooms. Certain records required by legislation were also examined. In addition, prior to the inspection a number of comment cards were issued to the home by the Commission, comments contained in returned cards from residents, relatives, visitors and associated care professionals have also been used to inform this inspection and report. What the service does well: What has improved since the last inspection? The home’s statement of purpose and guide has been updated since the previous inspection as have a number of the home’s policies and procedures. The majority of the improvements recommended by the Environment al Health Officer have been undertaken in the home’s kitchen. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 6 The residents’ request that the provision of two food items be discontinued has been acted upon, albeit not as promptly as they would have liked. It was noted that no fire doors were propped or wedged open during this inspection. An approved magnetic holdback device has been fitted to the office door so that it can be safely left in the open position when necessary. The RI has commenced documenting and supplying monthly reports of management visits to the home, as required. In September 2005, a quality assurance survey concerning the services provided in the home was undertaken an external agent; management are considering ways to address the outcomes. Five of the seven requirements set out in the previous report are now met. What they could do better: Service users, care plans and care related risk-assessments must routinely be reviewed each month and at times of significant change. A Building Control certificate regarding the improvements and alterations made to a bedroom on the second floor of the home in 2004 must be obtained and supplied to the Commission to demonstrate that the Building Control Officer is satisfied with the completed work. The damage to the inside of the lift door on the first floor must be mended. The improvements to the outdoor swimming pool should be implemented as planned and discussed at the last residents’ meeting. A programme of protecting central heating radiators where identified as a risk should be commenced to ensure that residents’ safety and independence is maintained. Residents meetings should be held every three months as requested by their chairman at the last meeting held in the home. The manager should seek the views of the care professionals who call into the home to ensure that information and concerns are regularly shared and addressed. The registered persons must concentrate on a staff recruitment programme commencing with the appointment of a new Head of Care or Deputy so that the manager works in an additional capacity to the staff team and has the time needed to fulfil home management and other important tasks. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 7 The staff training provided should be developed to include topics relevant to residents specific care needs, e.g., Memory loss, diabetes, the identification of abuse and adult protection. There are six requirements resulting from this inspection which must be addressed. 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. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6 Each prospective service user is subject to a pre admission assessment, which is undertaken by the manager to ensure that the home can meet assessed needs. The home does not provide intermediate care. EVIDENCE: The care records for one recently accommodated service user demonstrated that a pre-admission assessment of care needs was undertaken by the manager before the resident moved into the home for respite care. The assessment was comprehensive and a care plan drawn up to ensure that identified needs are met. The assessment was signed by the resident and manager. This particular admission also involved a variation to the registration certificate so that the person’s daughter could also share the room allocated. One resident confirmed they had stayed in the home for a trial period with his wife before deciding to stay permanently and commented: ‘ I feel very happy about the decision’. Terms and conditions of residence agreements are provided and also signed by service users Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Each service user has a care plan that identifies the care being provided to meet identified needs although they did not routinely evidence regular update when circumstances changed. This situation could lead to inconsistent care provision for service users. Service users’ health needs are monitored and responded to appropriately with support from community services. Service users confirmed their privacy is protected and that their known wishes are respected. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 11 EVIDENCE: The care records and care plans for five residents were examined and included details of personal hygiene, elimination, nutrition, mobility, sleeping, communications, safety, social activities, health, foot care and oral hygiene. It was noted that they had not been reviewed or updated since August. Care related risk-assessments were documented, but some need to be developed to include more specific information and regular review, for example the action to be taken by staff when a diabetic resident eats chocolate. Records evidenced that care reviews are undertaken regularly and involve the service users and/or their representative. Two service users confirmed they are include when decisions are made about their care and staff were observed consulting with residents about their care and preferences during the visit. One comment card notes, ‘we are extremely pleased with the overall care my uncle receives’ and another states, ‘I cannot fault the care given, 10 out of 10’. Accidents records are kept by the home and the manager undertakes a monthly review to establish any patterns and to prevent recurrence. Daily care records demonstrated that other care professionals are consulted appropriately for assistance and guidance. One comment card received from a community nurse identified that there had been a problem with a resident’s catheter care but the manager said no residents have a catheter fitted and agreed to discuss this with the nurse when they next visit the home. Two residents told the inspector that the staff respect their wishes and treat them with dignity. One said, ‘staff always knock my door a wait for me to answer before coming into my room’. Another said ‘ I lock my door when I go for lunch’. Both confirmed that staff promote their privacy and encourage them to remain as independent as possible. Each of the 11 comment cards received from service users prior to the inspection noted that privacy is respected and this was also confirmed in all comments from care professionals and visitors/relatives. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.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) 12, 13, 14 and 15 Residents confirmed that the lifestyle experienced in the home satisfies their expectations and enables them to continue with their independence. Visitors are welcomed by the home and social activities are creatively organised to provide additional interest for the residents living in the home. Individual care records indicate social care needs and are regularly reviewed with each service user to ensure their individual expectations and preferences are fulfilled. The meals and food supplied by the home are very good offering both choice and variety and catering for special dietary need. EVIDENCE: It was evident from conversation with the residents and through observation that the social care provision in the home is excellent. Care records evidence the activities programme on offer and notes when they are participated in. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 13 One resident provided a copy of the minutes from the last residents meeting held on 6th September 2005. It was noted that the residents’ requests for change are listened to and in most cases acted upon, for example a change in the menu or improvements to the environment. Eleven comment cards from service users confirmed they are satisfied with the activities provided by the home. There was good evidenced that residents are encouraged to maintain their independence and individuality, examples are as follows: one resident has written a book about the history of Steepleton Manor using his computer, several residents enjoy the art club and continue to paint, residents chair their meetings and at the last meeting it was agreed these would take place every three months and include residents’ relatives and representatives. The home does not hold money for service users the majority continue to manage their own financial affairs or are assisted by relatives or solicitors. Food records demonstrated that service users are supplied with a wide variety of healthy food with seasonal variations. A chef and a kitchen assistant are employed to work each day of the week including weekends. There is a large separate grand dining room which is attractively set out and decorated: an additional smaller dining room is available close-by for those service users who wish to eat their meals in a dining room where more privacy is afforded. One resident said that they had requested that chicken nuggets and new potatoes with their skins on were taken off the menu and this issue was discussed at the residents’ meeting: these items of food are no longer used. One resident said, ‘ the food is very good here’ while another commented that the food is ‘excellent’ and that they can have a glass of beer or wine with lunch and on special occasions. Nine of the 11 comment cards received noted that residents like the food offered, one stated that they sometimes like the food while another notes they mostly like the food provided. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.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) 18 The home has a policy concerned with adult protection to ensure that allegations of abuse are properly responded to thereby protecting service users in the home, but all staff have yet to be trained in this subject. EVIDENCE: A procedure for responding to allegations of abuse is available for staff reference in the home’s policies and procedure file and copy of the local ‘No Secrets’ guidance is also kept. The home has recently been subject to an adult protection investigation undertaken by the local Social Care & Health Office concerning the actions of a member of staff and the care of two residents. The investigation did not find evidence of abuse. The outcome recommends that consideration and review should be given to minimising long working hours, that the moving and handling policy be updated and staff training provided with regard to interpersonal skills. Staffing is referred to later in this report. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.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 and 26 Residents live in a home that has retained many original features, the communal facilities are comfortably furnished and pleasantly decorated and the majority of bedrooms are highly personalised. The central heating radiators are not protected; this means that vulnerable people are at risk. Residents confirmed that the home is always clean with no unpleasant odours and no apparent hygiene problems. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 16 EVIDENCE: Steepleton Manor is a very well maintained spacious period building set in attractive landscaped gardens in a rural location. There is an ongoing programme of restoration and refurbishment, all undertaken to a high standard providing very comfortable and elegant accommodation. The house is set in approximately 6 acres of spacious grounds, which are very well maintained. Patio areas sited in sheltered positions around the property with some areas accessed directly from service users patios doors. The home has an outdoor heated swimming pool and one resident said the facility would be used by more service users if hand grab rails were provided in appropriate places: this issue was also raised at the recent residents meeting. The manager explained that this matter has been noted and during the winter months some upgrading to the swimming pool will be undertaken. There is a grand gravelled driveway with a water fountain feature and a large car parking area. One relatives comment card highlighted the issue of ‘security’ and possible intruders and the inspector recommended that this matter be reviewed and risk-assessed. The inspector viewed the communal rooms and a selection of bedrooms. Service users bedrooms are available over three floors, the first and second floors being accessed by a small passenger lift. It was noted that the second floor corridor is currently being redecorated and that the inside of the lift door on the first floor is damaged. Since the previous inspection the hot water supply to washbasins has been governed by the fitting of fail-safe valves. The central heating radiators are not protected. Risk-assessments concerned with individuals safety and their vulnerability to scalding and burns have been drawn up, however remedial actions have not been identified. During the previous inspection it was noted that the home’s chimneystack had cracked and that scaffolding was being erected. The manager and one resident told the inspector that the chimneystack has to be rebuilt: the work has yet to be commenced. The previous report also identifies a requirement for a retrospective building control certificate to be obtained from the Building Control Officer in connection with alterations/improvements made to a bedroom on the second floor, which, has been altered, and another bedroom with a connecting door to this room. The 11 requirements set out in the Environmental Health Officer’s (EHO) letter dated February 2004 have been remedied but one recommendation concerning the provision of new floor covering in the kitchen has yet to be met. The EHO conducted another visit to the home in June and made further recommendations it is understood that the seal to the juice fridge has been replaced. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.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 and 30 The home is staffed each day by management, care and domestic workers to ensure that service users needs are met. A staff training programme is gradually being developed to include training related to resident’s specific needs. EVIDENCE: The pre inspection questionnaire notes that there are three staff on duty throughout the day and two wakeful staff on night duty between the hours of 8pm and 8am. Agency care staff are currently being used to cover care assistant vacancies and at times when unexpected shortfalls arise. However, this situation does not provide consistency of care to service users. The staff team includes the manager, head of care, senior staff, key-worker carers, an activities organiser, two chefs, two kitchen assistants, three general domestics and a maintenance worker/driver. Two residents expressed concern because five care staff have recently left and they are aware the remaining staff team are having to work extra hours. One of the key posts now vacant is that of Head of Care, whose role provided management cover when the manager was off duty, they also worked as part of the staff care team. The manager said that she is covering these shortfalls, however, she was hopeful that the immanent employment of an administrator would alleviate some of the workload/reception duties telephone enquiries etc. In addition, there is a general domestic vacancy. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 18 Two of the comment cards received from relatives noted the view that at times there are insufficient care staff available and most recently no –one senior to talk to. Three comment cards from care professionals identified that staff work long hours, that they have seen staff in tears and consider they need more specific training; residents have also apparently complained to them about their care. The manager agreed to discuss these issues directly with the community nurses to ensure that in future relevant information is exchanged before leaving the premises. The manager and Mr Cotterill explained that the home has advertised for staff and they are hoping to recruit at least one care staff from overseas. Residents said that staff were kind and caring but they are very busy at times and some work particularly long hours: while this situation is acceptable short term the manager realises that filling vacant posts is essential. New staff are supplied with training that meets NTO specifications and NVQ training is made available. Training directly related to the specific needs of service users has yet to be set up, e.g. diabetic care, memory loss, etc. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.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) 33, 35 and 37 The management have set up a quality assurance programme using an external agent to identify where development is necessary and this includes an annual survey of staff, residents and relatives’ views. The home does not manage resident’ financial affairs therefore safeguarding their independence. EVIDENCE: Mr Cotterill showed the inspector and manager the report from a recent quality assurance survey undertaken by an external agency. The findings were interesting in that they noted staff are happy at work in the home and service users are satisfied with the services provided. However, it also demonstrated that both residents and staff would appreciate a more personal approach from all of the management members who are involved with the home. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 20 During the inspection residents said that they feel their views are listened to but sometimes not acted upon promptly enough. One issue in particular being the passenger lift which has heavy fire doors to open, however, they appreciate this must be balanced by the restrictions on the listed building. The home keeps records as required by the Regulations and since the previous inspection Mr Cotterill (RI) has commenced documenting and providing reports of his Regulation 26 visits to the home: these visits provide general support and supervision for the manager and enable management to view the home from a quality assurance perspective. Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.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 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x 2 x 3 x 2 x Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 22 no 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 OP7 Regulation 15 Requirement Care plans must include all care needs and be updated at least monthly and at times of significant change. The care related risk-asssessments must also be developed to include more detail and regular review. A risk-assessment relating to a diabetic resident must be drawn up to include the actions to be taken when they eat too much chocolate. All staff must be supplied with training in the local No Secrets guidance: the manager and senior staff must undertake the advanced training available regrading the protection of vulnerable adults, as planned. The home must be able to evidence that all recommendations set out by the Environmental Health Officer have been remedied. A retrospective Building Control Completion certificate regarding the alterations made to a bedroom on the second floor of the home must be obtained and a copy supplied to the Commission.(previous timescales Timescale for action 31.10.05 2. OP9 13 (4) 31.10.05 3. OP18 18 31.12.05 4. OP19 23 (5) 31.12.05 5. OP19 23 31.10.05 Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 23 not met). 6. OP27 18 The registered persons must ensure that sufficient senior staff are employed so that the manager works in an additional capacity to the staff team and has sufficient time to undertake home management tasks. 31.10.05 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. 2. 3. 4. 5. 6. 7. 8. Refer to Standard OP18 OP19 OP19 OP19 OP19 OP27 OP27 OP27 Good Practice Recommendations The recommendations set out in the letter form Social Care & Health following an adult protection investigation should be acted upon. The chimney should be rebuilt as indictated by the council surveyor. The swimming pool should be upgraded as planned with grab rails in appropriate places for residents use. The registered persons should consider how The Old Stable bed-sitting rooms can be better ventilated. The issue of ‘security’ and possible intruders in the home should be reviewed and risk-assessed. The manager should liase with community nurses to discuss concerns identified in comment cardssen to the Commission. The staff recruitmnet programme should be focused upon to ensure that vacant posts are filled as promptly as possible. The home’s staff training programme should be developed to include topics directly related to the needs of the service users accommodated in the home, e.g. Diabetic Care, understanding sensory loss and Parkinson’s disease. (repeated from the previous report). A programme of guarding unprotected radiators should be implemented using a risk assessment process. 9. OP38 Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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 Steepleton Manor D55 S26874 Steepleton Manor V242482 270905 Stage 4.doc Version 1.40 Page 25 - 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!