CARE HOMES FOR OLDER PEOPLE
Sunningdale 5 North Park Road Manningham Bradford West Yorkshire BD9 4NB Lead Inspector
Sue Dunn Key Unannounced Inspection 3rd May 2006 09:30 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 Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 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. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Sunningdale Address 5 North Park Road Manningham Bradford West Yorkshire BD9 4NB 01274 510800 01274 543265 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) Crabtree Care Homes Mrs Georgina Melvin Care Home 32 Category(ies) of Dementia (32), Dementia - over 65 years of age registration, with number (32) of places Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th December 2005 Brief Description of the Service: This is a 32 bedded home for people with dementia, some of whom may be under 65, in the Manningham area of Bradford overlooking the park. A main bus route is close by. The home, which has recently had a change of name, is owned and operated by Crabtree Care Homes, a family run business. The building, a large Victorian house has been extended to provide additional single en suite bedrooms. Accommodation is on two floors with passenger lift access. Some of the very large rooms in the older part of the house are shared between two people. The walled garden surrounding the property has a parking area and has been pleasantly landscaped to provide secure outdoor walking and sitting areas. This allows residents the freedom to wander in and out of the house without restriction. Access to the property is through electric gates controlled with the help of CCTV cameras by staff from inside the house. The fees at the time of writing range from £412 - £440 per week. The following services are not included in the fees:- Hairdressing, Chiropody (private), personal clothing and toiletries and outings. A charge may be made to cover additional staff time needed for hospital escort duties. People are encouraged to bring personal items into the home and those who are funded by the local authority receive a weekly personal allowance of £19.10 from the fees paid. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The purpose of the inspection was to ensure the home was operating and being managed for the benefit and well being of the residents, all of whom have dementia. One inspector undertook the inspection, which was unannounced. The inspection started at 9.30pm and finished at 5.20pm. Some of the care files were taken away for closer inspection and returned to the home within two days of the inspection. A pre inspection questionnaire sent to the manager hadn’t been completed at the time of the inspection. Comment cards with pre paid envelopes were left in the home inviting people to express their views about the service. The report is based on information received from the home since the last inspection in December, observation and conversation with residents and staff, discussion with the manager, examination of five care files (which included case tracking two) and an inspection of the premises. This included an inspection of some bedrooms, all communal areas, the grounds and the progress of the building work to extend the kitchen and laundry. There has been an increase in the people with alcohol related dementias admitted to the home, resulting in a more active, mobile group of service users who are able, with support, to make choices about how they wish to lead their lives. The progress made by the manager and proprietors of the home has had a positive impact on the lives of the service users. What the service does well:
The interaction between staff and residents was good with a more balanced cultural, age and gender mix within the staff team, which benefits the service users. The manager has a good knowledge of each service user and uses her life and professional experience to relate to the people in her care in a relaxed and friendly manner. Service users are treated as individuals and encouraged to maintain their interests and skills for as long as possible. The home provides a secure environment with minimum restriction of movement around the building and garden area. The staff respond appropriately to service users questions and behaviours. These factors increase trust and reduce levels of agitation and aggression for the service users.
Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 6 The proprietors take an active interest in the home and people who live there and aim to provide a good service. If people are dissatisfied with the service, they are willing to listen, investigate and try to put things right. The proprietors are aware of the high level of wear and tear arising from the category of people they are registered to care for and have invested in a programme of redecoration and refurbishment to improve, and maintain, the home to an acceptable standard. They have recognised the need to extend the kitchen and laundry facilities and work on this is in progress. What has improved since the last inspection?
The Statement of Purpose has been revised. This document gives prospective service users and their representatives a clear picture of what the home can provide. A new pro forma for pre admission assessments has been introduced. This compensates for the poor quality of information provided by some other agencies and reduces the risk of people being admitted whose needs the home is unable to meet. One good assessment showed evidence that the service user had been involved in the process. The care plans, all of which had been written by the manager, showed some progress. It was not clear however if staff, service users and their representatives had been involved in the planning, though it was apparent during conversation with some service users that their views had been taken into account. The standard of personal care had improved with more attention to the detail of hair and nail care and suitable clothing. The records showed that when people refused bathing this task was picked up later, or an alternative approach was taken. The food served was freshly made and of high quality. The meal offered choices with sufficient for second helpings. There was little waste at the end of the meal. Those service users who could were encouraged to use their skills and were observed helping to clear plates, playing the piano, looking at the daily newspaper and discussing the state of the garden. Work to upgrade facilities in the home is ongoing, with evidence of improvements seen on each visit. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 7 What they could do better:
Contracts must be signed to show evidence that people understand the terms and conditions of occupancy and are aware of the room they are to occupy. There should be more evidence in care plans to show that service users and their representatives views are taken into account. Social and recreational, spiritual and cultural needs should also be included, as the care plans did not reflect good practices observed on the day of the inspection. There needs to be evidence in the daily records to show that staff follow the guidance in the care plans. Staff were spending time writing in care files but giving little information about the care and events in each service users day which had added to their quality of life. Daily notes did not show evidence that care was being followed through between shifts, as in the case of an entry about a sore throat. Care plans must show how the home plans to meet the present and future needs of people from different cultures whose first language is not English. This should include some acknowledgement of dietary preferences. Staff must be able to demonstrate that they understand the purpose and effects of the medication they are giving. It should not be assumed that one bath a week is satisfactory for all. Care plans must provide guidance on the minimum level of personal care each week for each individual. The attitude of staff has improved and the manager felt there was more cooperative teamwork. However there were still some undertones of a culture of ‘its not my job’ ‘I didn’t do it’. All the staff could benefit from customer care training to raise their awareness of how their approach reflects on the reputation of the home. The level of odour control was not acceptable in some parts of the home. Staff were aware of the home’s procedures for reducing the risks of cross infection but the procedures were not being followed. Infection control training (which is on the training programme for this year) must be given high priority. The manager should be given the opportunity to update her knowledge of good practice in dementia care through specialist journals and conferences, which draw together other specialists in this area of care. It is recommended that the manager look at ways in which the environment of the home can be improved for people with dementia. Hold open devices linked to the fire alarm system should be installed on those doors where service users wish them to stay open. Furniture and wedges must not be used to prop doors open. Recruitment and selection procedures must provide evidence to show information has been thoroughly checked and how interviewers reached their decision to employ a candidate. All records must be dated and maintained as required by the regulations. The name on one record was incorrect and training records did not show the date training had taken place and some care assessments were undated. This makes it difficult to track and review a service user’s progress. The records of income and expenditure for each service users must be accessible for inspection.
Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 8 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. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 9 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 Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 2, 3 and 4 Information is available to enable people to make an informed choice about the home but there was no evidence to show if they had received the information. The pre admission procedures had been improved to avoid the admission of people whose needs could not be met. The home does not provide intermediate care. EVIDENCE: The proprietors have recently revised the home’s Statement of Purpose. A copy of the contract of terms and conditions of occupancy was inspected in one of the files. As the document had not been signed by the resident or his representative there was no evidence that they had seen the contract or were aware of the terms and conditions of the occupancy. The care files of people admitted to the home more recently contained assessments carried out by the home before admission. The content of the information given to the home from the hospital was very poor in one case and the pre admission information carried out by the home limited by the restrictions of the pro forma. Another assessment using the new pro forma was comprehensive and showed evidence of discussion with the service user. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 7, 8, 9 and 10 Residents care needs were being met but the good practices observed were not fully evidenced in the care plans. The plans showed some development but need more work to show how social, recreational, spiritual and cultural needs are to be met. Staff need more training and support in how to record relevant information and accredited training in handling and understanding medication. EVIDENCE: After speaking to residents and staff and observing people going about their daily routines, five care files were inspected. People were seen to be clean and neatly dressed with well cared for hair. Staff had recorded when personal care such as bathing had been given and showed that an alternative approach was used when necessary. It appeared that there was an assumption that one bath or body wash a week was sufficient. This should be seen as a minimum requirement. There was good interaction between staff and residents and, with one exception, staff were discrete when assisting and prompting people who
Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 12 required help with personal care. The atmosphere was calm and staff approached each resident in a way which avoided confrontation. The care plan format provided a consistent way of recording needs and guiding staff on what to do to meet the needs. However much of the good practice observed was not recorded in the care plans. Some care files had good background history and it was evident that in some cases this had been used to maintain familiar interests and activities in the wider community. The daily notes showed that some staff recorded information relevant to the care plan and described the support they had given. The majority of entries however were repetitive and did not give any useful information. For example, one person recorded that a resident had complained of a sore throat but did not say if anything had been done about it. There was nothing in the notes to show if staff on later shifts had checked this. Care plans for a person whose first language was not English did not show what arrangements were in place to meet needs though it was clear from observation, discussions with the resident and the manager and entries in the daily records that support was given to maintain contact with her own community. The care plan did not show whether the home had planned ahead for dietary preferences or had a clear plan should a translator be required. The lunchtime medication, given by a senior member of staff, ensured the security of the contents of the medication trolley throughout the process. However, an out of date liquid medication was about to be given, until this was pointed out, and information about the purpose of the medications currently in use, which was said to be kept with the medication records, was ‘missing’. Staff have not had accredited training on the safe storage and administration of medicines. Care plans did not describe the wishes of residents or their families in the event of their death. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Service users are supported to maintain contact with family and friends and restriction of movement and choice is kept to a minimum. Service users appeared contented with the low-key activities based on routines of daily living, their own skills and the interest and conversation of staff and each other. There was no evidence of forward planning for this in the care plans. The food was of a high standard providing a varied and nutritious diet, which took into account individual choices. More could be done to introduce dishes from the countries of origin of some people in the home. EVIDENCE: A good level of interaction was seen throughout the day between residents and staff. Overall, the group of people in the home is quite mobile and individuals were seen to move freely about the home. Some people were in their rooms and several residents were outside sitting on garden benches smoking and talking. Two people walked around the garden with the inspector, discussing the weather, plants and gardening. One said, ‘I have a pal who helps me in the garden’ and talked about weeding some of the raised beds. The manager said she would get her a weeding tool for the dandelions. It was clear that the outside area was a source of pleasure. There was a daily newspaper and one
Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 14 person has a weekly TV times. One person was playing her electric piano for the benefit of anyone who cared to listen. Two people were singing along to the tunes. A cupboard for activity materials is to be fixed in a secure area as many materials have in the past gone missing. A large screen TV in one of the lounges can be watched as a matter of choice. At least three people attend clubs and churches outside the home with the assistance of friends. The manager said some people go with staff to the local shops and two people had been to the fair in the local park the previous weekend. There were no care plans for social and recreational activities for each person though this was clearly happening and only occasional entries had been made in daily records to evidence activities, which improved quality of life. The main meal from fresh produce offered two choices, which were well cooked and tasty. Some people had second helpings and there was little waste. The cook had spoken to all the residents and found nine people who would like salads during the summer period. The mealtime was relaxed with no pressure placed on people to finish eating quickly. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The people acting on behalf of service users have their views listened to, taken seriously and action is taken to resolve issues. People living in the home can be sure that their rights are protected and that they are safe from abuse. EVIDENCE: The proprietors welcomed the investigations by the CSCI last year into two anonymous complaints. The findings of the investigation were used to change staff practices in the home. This resulted in a noticeable improvement seen on this inspection in the level of personal care and quality of life for the people living in the home, as shown earlier in the report. The proprietor has provided the CSCI with copies of letters sent to complainants following his own investigation into any concerns brought to his attention. These have shown that all complaints are taken seriously and efforts made to resolve any issues. During the inspection it was noted that there is still an underlying attitude of staff not being prepared to take responsibility for their actions as a team and responding to questions with ‘I didn’t do it’ rather than ‘I will put it right’. A complaint since the inspection about the ability of the home to meet the needs of one person has been sent to the provider for investigation. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26 There are systems in place for repairs and renewals. There is evidence of this in an overall raising of standards since the present proprietors took over the home and there is a more ‘cared for’ atmosphere. Some work is needed to maintain satisfactory levels of odour control in all parts of the home. Staff were not following procedures to reduce the risk of cross infection. Training must be given high priority for the protection of service users. The environment could be improved by more signing cues around the building to help service users find their way around the home EVIDENCE: The proprietors are improving the laundry and kitchen facilities by extending these areas. The building was well underway without any disruption to the normal operation of the home. Bedrooms and lounges have been redecorated and furnished since the present proprietors took over the home and there has been an improvement in the
Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 17 overall standard of cleanliness. However, the control of unpleasant odours was less effective than on the last visit. A further extension is planned to add eight more bedrooms and more communal and bathing space in the home. The existing rooms do not have hold open devices linked to the fire alarm system. The electric gates were not working properly due to a faulty part. Staff were having to physically close the gates after each visitor. The repair to the gates was being completed on the inspector’s return to the home two days after the inspection. A maintenance person is employed to carry out any general repairs around the home. The manager is aware that the ground floor communal toilets need refurbishing and is awaiting an estimated cost for the work to be carried out. An extra door has been fitted to this area in the interests of privacy and some attempts have been made to improve the signage. More could be done to identify different areas of the home for the benefit of the service users. Hand washing and drying facilities were available in all toilets and bathrooms and staff had been given a copy of the procedures for avoiding cross infection, which the person doing the cleaning was able to describe. The colour coding system for cleaning cloths was not being followed although there were stocks of different coloured cloths in the storeroom. During an outbreak of diarrhoea and vomiting earlier in the year an infection control inspector reported that staff were not following procedures to limit the risk of cross infection. It was of concern to note that staff have not yet had infection control training. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The numbers and skill mix of staff was sufficient to meet the needs of the service users. Staff worked hard and showed commitment to the needs of the people in the home. Recruitment procedures, in place to protect service users, need to be followed more rigorously. The staff training and supervision programme aims to train the staff to a level of competency, which enables them to understand and meet the needs of the service users. However it was noted some staff were not putting into practice what they had been taught. EVIDENCE: There is a more balanced cultural mix within the staff team to reflect the cultural backgrounds of the people living in the home. New staff had to complete a formal induction programme, which included recorded evidence. The inspector was shown an example of induction books which are to be introduced which ask for more detailed evidence to show that staff understand the home’s procedures. A new member of staff confirmed that she was working through her induction book, which had been left at home. An evening deputy post has been introduced to ensure standards of care are monitored and maintained in the absence of the manager. The training records were well organised and easy to follow with an individual sheet for each member of staff giving an overview of each person’s training. The records should show the dates that training has been completed not just say ‘done’ as this does not indicate when updates are due.
Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 19 The records showed that 9 staff had attended the training to update their moving and handling skills and there is a rolling programme of fire safety training. Staff get some support with child care for in house courses so incur a financial penalty if they fail to attend. A false fire alarm during the inspection revealed that staff understood the procedures. Nine staff have achieved a NVQ award. The recruitment and selection records showed that CRB checks had been undertaken. However further improvement must be made in this area as follows: - One of the files did not have an ID photograph, The name on one of the personnel files did not match the name on the application form, None of the files included a job description or employment specification, One employee only had one written reference, interview notes were in one file but not sufficiently detailed to show that gaps in employment history had been checked. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 37 and 38 The home is well managed and the interests of the residents are seen as very important. There has been an improvement in staff morale and commitment since the last inspection. Overall records were well maintained. Income and expenditure records for service users could not be inspected as they were held at the head office. EVIDENCE: The manager has the skills and experience to manage the home but would benefit from further development opportunities related to the care of people with dementia. Service users benefit from her good knowledge of their needs and she tries to pass this on to staff by example, handover meetings and care plans. The proprietors of the home offer good management support. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 21 The care files were consistent in layout making it easy to find information. Some assessment records, such as Waterlow assessments of physical care needs were undated and unsigned. These must be dated to allow any progress or deterioration to be effectively monitored. Risk assessments were stored in a plastic folder in the files therefore the areas of risk identified and the way the risk was to be reduced was not immediately apparent. It is recommended that any plan to minimise risk be shown on the front index of the documentation. The records of income and expenditure on behalf of residents was not available as this is held at the company’s head office. Arrangements must be made to give the registered manager access to the information. This is outstanding from previous inspections. Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x 2 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 2 x 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x x 2 2 Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 23 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 OP2 Regulation 5 Requirement There must be evidence to show that service users or their representatives have received and understood the terms and conditions of occupancy Wherever practicable care plans must show that service users or their representatives are involved in the preparation and review of plans. Care plans must include the social, recreational spiritual and cultural needs of the service users Timescale for action 31/08/06 2. OP7 15 31/08/06 3. OP7 17 4 OP26 The records held in respect of each service user must be dated and be detailed enough to show the care being given 13, 16, 18 Infection control training must be given high priority. Effective measures must be in place to keep unpleasant odours under control Staff must have medication training which meets the British Pharmaceutical Guidance for handling medication in care
DS0000060012.V292152.R01.S.doc 31/08/06 30/09/06 5. OP9 13,18 30/09/06 Sunningdale Version 5.1 Page 24 6 OP29 19 7 8. OP31 OP37 10 17 homes and to understand the purpose and effects of the medication they are giving Recruitment and selection procedures must be sufficiently robust to provide assurances that service users are protected The manager must keep up to date with current practices in the care of people with dementia Records of financial transactions on behalf of residents must be available and in sufficient detail to show that residents interests are protected. This is outstanding from the last inspection The manager must ensure as far as is reasonably practicable that the safety of service users is protected by ensuring that suitable hold open devices are fitted to those doors which remain open. 31/08/06 31/12/06 31/07/06 8 OP38 23 31/07/06 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. Refer to Standard OP22 OP32 OP33 Good Practice Recommendations The manager should seek information about ways in which the environment of the home can be improved for people with dementia Consideration should be given to providing customer care training for staff to improve teamwork and communication. Regulation 26 reports should include an agreed plan for action Sunningdale DS0000060012.V292152.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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