Inspection on 18/04/07 for Strathmore House

This inspection was carried out on 18th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Strathmore House 08/09/08

Strathmore House 11/10/07

Strathmore House 10/11/06

Strathmore House 19/04/06

Strathmore House 07/11/05

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 Strathmore House Friday Bridge Road Elm Near Wisbech Cambridgeshire PE14 0AU Lead Inspector Janie Buchanan Key Unannounced Inspection 18th April 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Strathmore House DS0000066352.V335769.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. Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Strathmore House Address Friday Bridge Road Elm Near Wisbech Cambridgeshire PE14 0AU 01945 860569 01945 860202 strathmore.house@ashbourne.co.uk www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited 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) Mrs Denise Marie Abrook Care Home 46 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (46), of places Terminally ill over 65 years of age (25) Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Maximum of 25 TI(E) beds Maximum of 20 DE(E) beds Maximum of 46 OP Date of last inspection 10th November 2006 Brief Description of the Service: Strathmore House is situated in secluded mature gardens set back from the road between the villages of Elm and Friday Bridge. It is a large 18th century house that has been extended beyond its original to provide the present facilities. Accommodation in the old house is on two floors with the first floor being accessed by a shaft lift. There is a variety of sitting areas and a dining room. The extended area of the house is single story and within this area is a self-contained unit for older people with dementia. A detached bungalow next to the main house has accommodation for six people. The home currently accommodates 39 residents. Weekly fees range from £340 for local authority funded residential care to £680 for service users receiving privately funded nursing care. Additional charges are made for newspapers, hairdressing and private chiropody. The inspection report is available on request from the manager. Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place on the 18 April 2007, it was unannounced and was undertaken by three inspectors. Two inspectors spoke with five residents, four members of staff and the manager. A specialist pharmacist inspector checked the home’s medication procedures. A tour of the home and kitchen was undertaken, and a range of documents was viewed. No residents’ or relatives’ comment cards were received by the Commission for Social Care Inspection, despite these being sent well in advance of the inspection to the manager for distribution. The home has been subject to two additional inspections (24/01/07 and 15/03/07) since its last key inspection, because of concerns about the poor quality of the service provided. Details of these reports are available by contacting the Cambridge and Peterborough office of the Commission for Social Care Inspection on 01223 771300. Only eight of the 22 standards assessed were fully met, and 17 requirements have been made as a result of this inspection. This is a very poor result and the home will be subject to increased inspection from the Commission for Social Care Inspection. What the service does well: What has improved since the last inspection? There have been some improvements in the decoration of the home since the last inspection. The library and corridors have been painted and now look much fresher; lighting is brighter on the dementia care unit and enables residents to see better; and some areas of the home have been re-carpeted. Although there was a strong smell of stale urine in one bedroom, generally areas of the home were free from strong odours. As the result of an Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 6 enforcement notice, a fully operational call bell system has now been installed and will enable residents to call for attention when they need it. Cleanliness in the kitchen has improved. Floors, fridges and shelves were clean, and food was correctly stored and dated. Daily, weekly and monthly cleaning schedules have been introduced to help maintain levels of cleanliness. What they could do better: 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. Strathmore House DS0000066352.V335769.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 Strathmore House DS0000066352.V335769.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): 2, 3, Quality in this outcome area is adequate. Residents’ needs are assessed before moving into the home, and they have information about the terms and conditions of their stay there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files of three recently admitted residents were viewed and all contained satisfactory pre-admission information about their needs. The files also contained contracts that gave details of the fees to be paid by residents, the accommodation and care to be provided, and the proprietor’s obligations. None of the residents spoken to said that they had visited the home before moving in, although some stated that their relatives had visited on their behalf. The home does not provide intermediate care. Strathmore House DS0000066352.V335769.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): 7,8,9,10 Quality in this outcome area is poor. Residents are not fully involved in planning and reviewing their care and are not always treated in a respectful and dignified manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are not actively involved in drawing up and reviewing their plans of care and staff reported that residents’ ‘rarely’ or ‘never’ get to see their plans. The inspector showed two residents their care plans: both stated that they had never seen them before, despite both being very able to read and understand their plans. There was evidence in some plans of good health care treatment and intervention, and turning charts were in place for residents at risk of pressure sores. However, one resident’s care plan showed that he was at significant risk of malnutrition, and had lost a considerable amount of weight in a short space of time. It clearly stated in the plan that this resident was to be weighed weekly as a result. In spite of this, records showed that he had not been weighed since 25/03/07. Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 10 Staff spoken to gave good practical examples of how they maintained residents’ dignity and privacy when helping them with personal care. One staff member talked of the great importance of letting residents do as much as possible for themselves so that they can maintain their independence. One resident commented ‘my bath was done beautiful, by a man!’ However, when the inspector was talking privately with one resident in her bedroom a staff member barged in without knocking, and proceeded to remove some dirty dishes from the room. This member of staff did not ask the resident if it was OK for her to do this, and this intrusion very much disrupted the inspector’s conversation with the resident. Another member of staff was observed feeding a resident whilst standing over her, and another staff member spoke very sharply to a resident on the dementia unit, and told him off publicly for accidentally using the pepper pot, instead of the salt pot. (This problem could be easily remedied by using pots with a large and visible P and S to indicate their contents, so that residents do not get confused). Each resident had a designated key worker to ensure they get additional support and there was a poster in each residents’ bedroom indicating who their key worker was. However none of the posters on the ground floor had been filled in, and residents were not aware of their key worker. Staff struggled to tell the inspectors which residents they actually key worked. The home has good written policies and procedures for the safe use and administration of medicines but there is clear evidence that staff are not following these procedures, nor that they are aware of what they contain. Medication prescribed for residents receiving nursing care is administered by nurses and for those residents who receive personal care only, medication is administered by senior care staff. The level of training provided to senior care staff to enable them to do this safely and effectively is basic and must be improved. There are no assessments that people who administer medicines are competent to do so. Described procedure for obtaining medicines mean that staff do not order the prescriptions from the prescribing GP, but leave this to the supplying pharmacist. This also means that staff do not have sight of the original signed prescription from the GP and a copy is not retained to be able to validate the prescribed instructions. The medication “round” was observed during the morning of the inspection and, on the whole, was carried out with due regard to the wishes and dignity of residents. However, the trolley carrying medication was left unattended in openly accessible areas which carries a risk the medication may be taken inappropriately and an immediate requirement notice was served about this. Storage facilities provided for medicines are adequate and secure. The temperature of the storage room was adequate but no monitoring or recording is made of this which is a requirement of the home’s own policy. The fridge used to store medication also contained pathological samples which is Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 11 unacceptable practice. The fridge temperature is recorded on a daily basis but the maximum temperature reached has been recorded above the recommended maximum of 8C without any action taken by staff to investigate the performance of the fridge or the quality of medicine stored in it. The home’s own policy document states that the “temperature should be between 2 – 8 C, if the temperature is outside the max/min limits the manager should be informed immediately.” This is not being followed. The cupboard in use for the storage of medicines controlled under the Misuse of Drugs Act 1971 conforms to the relevant regulations but is too small and so some controlled drugs are not stored within this cupboard but in an outer cupboard which does not comply with the Misuse of Drugs (Safe Custody) Regulations. A small container was found in the controlled drugs cupboard which contained an unidentified purple tablet. Stock levels of medicines were at a reasonable level, given the size of the home but there was evidence that medicines were not disposed of promptly when no longer prescribed for residents. Some medicines were found for a service user who had not been resident in the home since December 2006. Some medicines were administered to residents from shared containers even though they carried another resident’s name. An immediate requirement notice was served about this. Records of medicines received and disposed of were adequate for most medicines but there is a tendency not to record the date of receipt of medicines when they are received outside the normal ordering cycle. This means that their use is difficult to audit since a fully accountable trail is not possible. Records of the prescribing and administration of medicines showed some worrying deficiencies, including, but not limited to: An unacceptable number of gaps in the administration records giving no indication of whether medicines are administered or not When medicines are prescribed in variable doses, the number of doses given is not recorded. The administration of prescribed creams and ointments simply recorded as a tick, giving no indication of who administered the treatment. Medication not administered to residents in accordance with the prescribed instructions. An immediate requirement notice was served about this. Records of the administration of medicines not made at the appropriate time, but some time later. Where residents frequently refuse to take medicines there is no evidence that this is reported to the prescribing GP. Records of the results of GP and other professional visits were limited and did not give clear indication of the results of such consultations. Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 12 Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Quality in this outcome area is good. Activities in the home provide stimulation and entertainment for residents This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are a variety of activities available for residents to enjoy and include crafts, outings, games and musical entertainment. One resident particularly enjoyed a trip to a local church for an Easter service. Residents reported that they receive visitors regularly and one was pleased that when her husband visited every morning he was made to feel welcome by staff. Residents confirmed that there was a choice of two dishes at lunch, and a hot meal at teatime. On the day of inspection itself lunch consisted of chicken casserole or meat pie, with potatoes, carrots and beans. Residents are asked each day which they prefer and the menu was displayed around the home. However lunch was served fully plated up, thereby denying residents choice of what, and how much, they wanted to eat. This practice is a little institutionalised. Strathmore House DS0000066352.V335769.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): 16, 18 Quality in this outcome area is poor. Residents concerns and complaints are not taken seriously. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information about how to complain is on display on a notice board in the hallway, but the print is very small and not easily readable for residents with visual impairments. It was also too high up on the wall for residents who use wheelchairs to view. None of the residents spoken to were aware of the home’s complaints procedure; of more concern was that a senior member of staff was also unaware of the home’s complaints procedure. The manager stated that there had not been any complaints in the last year. However, two staff members told the inspectors of a serious complaint that had been raised by the daughter of resident in the home. The daughter had reported it to the manager. Details of this complaint had not been recorded and it was not clear what action, if any, had been taken in its light. Residents had repeatedly raised various concerns at their monthly meetings including the lack of hot water, the lack of a functioning call bell system, the lack of a safe pathway, the need for garden furniture and various problems with the food. However none of these issues had been formally recorded, or responded to. Staff have received training in protecting vulnerable adults. Strathmore House DS0000066352.V335769.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): 19, 20,21,26 Quality in this outcome area is poor. Residents live in a home that is badly maintained and looks shabby and neglected. Residents do not have safe access to fresh air and sunlight. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The environment of the home’s dementia care unit is good. There are interesting ‘fiddle boards’ along long corridors for residents to stimulate and occupy themselves with. Different coloured bedrooms doors and pictorial representations of toilets and bathrooms help residents find their way about. However, some aspects of the home’s environment continue to be poor: • • Woodwork around the front door to the home was chipped and rotten. The concrete doorsill was broken and uneven, causing a trip hazard for residents. There was a strong smell of urine in bedroom 42 Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 16 • • • • The upstairs bathroom contained an old bed head, mattress, pressure relieving equipment and bedside table, thereby denying residents access to it In the bathroom in the Snowdrop unit a hoover was blocking access to the sink and a mop and bucket was being stored in the actual bath. The lino was badly stained Paintwork in the hallway of Snow Drop unit was scuffed and unsightly An old call bell point, in addition to a new one, was still on the wall in the toilet of Snow Drop unit. This could cause confusion for residents trying to call for help. The grounds at the back of the home, although extensive, were unmown and inaccessible to residents. There were a number of hazards to residents in the back garden including a large pile of hardened concrete, open tins of paint, a discarded lawnmower, a broken chair and a rusting wheelchair. There was no garden furniture for residents to sit on. Although staff were sitting outside, clearly enjoying the warm and sunny weather, no residents were being given this opportunity. Strathmore House DS0000066352.V335769.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): 27, 28,29,30 Quality in this outcome area is adequate. Residents’ needs are met by the number of staff on duty. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels at the home are good with seven staff on duty in the morning, and six on in the afternoon to meet the needs of 39 residents currently. Four staff are on duty at night. Staff themselves stated that these levels allowed them to do their job well, and also have one to one time with residents. Residents stated that they rarely waited a long time for help. However, it was of concern that 21 staff had left the home in the last 12 months: this is an unusually high number. The personnel files for three recently employed members of staff were viewed. Each contained evidence that appropriate references and CRB/POVA checks had been undertaken. However there were considerable gaps in employment noted in two CVs submitted by these prospective employees. The reason for these gaps had not been explored as part of their recruitment. 75 of staff hold and NVQ level 2 in care, which is well above the recommended standard of 50 . Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 18 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): 32,33,36,38 Quality in this outcome area is poor. Residents are at serious risk due to poor management of health and safety within the home. The concerns of both residents and staff are ignored. This casts doubt on the manager’s ability to run a home for older people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff supervision in the home continues to be poor. Two members of night staff have still not received any supervision whatsoever, despite this being a requirement made at previous inspections. Even when staff had received supervision, it was not as frequently as recommended by the standards. Staff have spoken to the inspector on two separate occasions about problems and discrepancies in their pay. They reported that they had raised the issue many times but felt nothing had been done. Staff were clearly angry and Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 19 frustrated at the length of time it was taking to sort out, and had little faith in the senior management of the home as a result. No formal quality assurance or monitoring tools have been implemented in the last year. There are regular residents meetings, however residents concerns are blatantly ignored. For example, one resident requested in the meeting of April 2006 that the pathway from the bungalow to the main home be retarmaced because the holes in it made it uncomfortable for her in her wheelchair. She raised this issue again in the meetings of 15 August 2006, October 2006, and December 2006, January 2007 and March 2007, when she reported that she had nearly fallen out her wheelchair due to the uneven pathway. The pathway was eventually retarmaced in April 2007, over a year later. Similarly residents reported problems with the call bell system at their meetings of January 2006, and again in March 2006, May 2006, July 2006 (where residents stated they felt insecure without it), August 2006, December 2006, January 2007 and March 2007 (where one resident stated he was wet in the night and could not get hold of a carer as there was no call bell to use). The manager has clearly been aware of problems with the call bell but has done little to resolve them despite the significant risk it poses to residents. Following a statutory enforcement notice issued by the Commission for Social Care Inspection, a new call bell system is now in place Problems with the home’s boiler system have been ongoing including dangerous emissions of carbon monoxide, faulty thermostats and the complete breakdown of the system in November 2006, leaving residents without heat during a cold spell. It is the understanding of the inspectors that the heating presented problems last winter (2005) and the providers were advised that the system needed to be drained and overhauled. No action was taken over the following summer months. One boiler has now been completely condemned, leaving the home to run on one boiler only, and residents vulnerable yet again to no hot water or heat. The following items seriously compromised the health and safety of residents living at the home: • • • • • • • Two night staff had not received training in moving and handling One member of day staff, who is pregnant, has not received any training in moving and handling in nearly 3 years None of the staff hold current first aid certificates Temperatures were not monitored in fridges in the home’s various accommodation units Uncovered and undated food was found in these fridges A fire door in Snow Drop cottage was held ajar by a laundry basket. This prevents it from closing in the event of fire and puts residents at risk. A fire door in room 32 was held ajar with a newspaper as the closing mechanism had broken Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 20 • • • The carpet was worn and rising up in room 52 and could pose a trip hazard for residents Paving around the outside of the home is broken and full of pot holes, causing major trip hazards to residents a prescribed cream was found unlocked in a resident’s bedroom Strathmore House DS0000066352.V335769.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 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 1 10 1 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 1 17 x 18 3 1 1 1 x x x x 2 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x 1 1 x x 1 x 1 Strathmore House DS0000066352.V335769.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. No. 1. Standard OP7 Regulation 15(2) (c) Requirement Residents must be actively involved in drawing and reviewing their care plans so that they can contribute, and agree, to how they are to be assisted. Residents must be given medication in accordance with the prescribed instructions from a container dispensed and labelled for them individually. An immediate requirement notice was served. 3. OP9 13(2) Medication prescribed for 20/04/07 residents must be stored, recorded and administered safely and appropriately. An immediate requirement notice was served. 4. OP9 13(6) Staff authorised to administer medicines must be trained and assessed as competent to do so. 01/06/07 Timescale for action 01/06/07 2. OP9 12(1) 20/04/07 5. OP10 12(4) Residents must be spoken to and 01/05/07 treated in a respectful manner, DS0000066352.V335769.R01.S.doc Version 5.2 Page 23 Strathmore House 6. OP16 22 (2-6) and their privacy must be maintained. The complaints procedure must be in a format accessible to residents and any complaints made must be fully recorded, investigated and the outcomes fed back to the complainant. Timescale of 01/05/06 not met. CSCI is seeking legal advice in relation to continued breach. All areas of the home must be properly maintained so that residents live in a safe and pleasant environment. In particular, items of maintenance listed under standards 19-26 of this report must be addressed. Timescale of 01/07/06 not met. CSCI is seeking legal advice in relation to this continued breach. Gardens around the home must be made improved so that residents can have access to fresh air and sunlight. Timescale of 30/10/06 not met. CSCI is seeking legal advice in relation to this continued breach. The registered person must keep the care home free from offensive odours. Timescale of 01/04/07 not met. Gaps in the employment history of prospective staff must be fully investigated to ensure the safety of residents. Effective quality assurance systems, based on seeking the views of residents must be implemented, to ensure that the DS0000066352.V335769.R01.S.doc 08/06/07 7. OP19 23(2)(b) 08/06/07 8. OP20 23(2)(o) 08/06/07 9. OP26 16(2)(k) 01/06/07 10. OP29 7,9,19 01/05/07 11. OP33 24 (1) 01/06/07 Strathmore House Version 5.2 Page 24 home is run in the best interests of those residents. Timescale of 31/12/05 not met. Staff must receive regular supervision to ensure their working practices meet the needs of residents. 12. OP36 18(2) 08/06/07 13. OP38 13(4) Timescale of 30/04/07 CSCI is seeking legal advice in relation to this CSCI is seeking legal advice in relation to this breach. breach. All parts of the home that 08/06/07 residents have access to must be kept free from hazards to their safety. All items listed under standards 31-38 of this report must be addressed. Timescale of 28/02/07 not met. CSCI is seeking legal advice in relation to this continued breach. There must be at least one first aid trained person in the home at all times, to make sure that residents receive appropriate treatment in an accident. Moving and handling training must be provided for all staff so that residents can be transferred safely. Previous timescale of 30/12/06 not met. The condemned boiler must be replaced so that residents can be assured hot water and heating. Fire doors must be not be pinned back, preventing them from closing in the event of a fire. 14. OP38 13 (4) 01/06/07 15. OP38 13 (5) 01/06/07 16. 17. OP38 OP38 23(2)(p) 23(4) 01/06/07 19/04/07 Strathmore House DS0000066352.V335769.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 OP9 Good Practice Recommendations Review the procedure for the ordering of prescriptions and medicines so that staff have sight of the original signed prescription before it is dispensed and a copy is retained for future reference. Strathmore House DS0000066352.V335769.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Strathmore House DS0000066352.V335769.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. 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