Inspection on 09/02/09 for The Dales

This inspection was carried out on 9th February 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Dales 11/06/09

The Dales 06/03/07

The Dales 09/02/06

The Dales 26/07/05

The Dales 14/03/05

The Dales 14/01/05

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Dales Woodhall Road Off Gain Lane Bradford BD3 7DR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Denise Rouse     Date: 1 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 31 Information about the care home Name of care home: Address: The Dales Woodhall Road Off Gain Lane Bradford BD3 7DR 01274656110 01274665800 listerju@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : BUPA Care Homes (GL) Ltd care home 108 Number of places (if applicable): Under 65 Over 65 0 108 dementia old age, not falling within any other category Additional conditions: 108 0 The maximum number of service users who can be accommodated is: 108 The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either, whose primary cre needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP and Dementia - Code DE Date of last inspection Brief description of the care home The Dales is owned by BUPA. It is in a central position on the Leeds/Bradford border. The main road, Gain Lane, is well served by public transport. Visitors on foot then have a reasonable walk up Woodhall Road to reach the main reception area. The site is know collectively as The Dales, but is split into five separate units. Four units provide nursing care to residents who have a diagnosis of dementia or related conditions. One unit is used for residents who may not need to be in a nursing home but can be looked after in a residential setting. Each unit is self-contained with a range of lounges, dining areas, kitchenettes and Care Homes for Older People Page 4 of 31 Brief description of the care home bathrooms, some of which have specialist equipment. A lot of the bedrooms have ensuite facilities. Residents are encouraged to bring personal items such as ornaments, pictures and small pieces of furniture with them when moving in. On 9 February 2009 the fees charged ranged from £500.00 per week for residential care, rising up to £600.00 per week for nursing care, depending upon the size of the bedroom to be occupied. Additional charges are made for hairdressing, newspapers and private chiropody treatment. Care Homes for Older People Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A review of the information held on the homes file since its last inspection. Information submitted by the registered provider in the Annual Quality Assurance Assessment, AQAA. Surveys were requested to be sent to the home, however these were not received by the home for people to complete and return. An unannounced inspection was carried out by two inspectors over two days. Evidence was gained by direct observation during these site visits. The inspectors spoke to people living at the home, and spoke to visiting relatives. The inspectors also spoke to Care Homes for Older People Page 6 of 31 the nurses, care staff and kitchen and maintenance staff, and to the Clinical Services Manager who assisted the inspectors during the site visit. Feedback was given to her and to a supporting manager from another BUPA home at the end of the two days. A Short Observational Framework Inspection (SOFI) was carried out which gave us some information about how people were engaged with by the staff and how the people were stimulated by their environment and surroundings. We looked at a variety of records including care profiles, medication administration records and some policies and procedures were also inspected. We have reviewed our practise when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. But only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will take place. What the care home does well: What has improved since the last inspection? What they could do better: The home environment requires a refurbishment which needs to be extensive. Care Homes for Older People Page 8 of 31 Littendale is the most modern unit which has the best facilities, however the refurbishment programme should be undertaken to make sure that all areas of the home are pleasant for people to live in. Care plans should be reviewed monthly to make sure that people are receiving the care they currently need. Health and safety issues must be identified by staff and acted upon quickly to make sure that people are not placed at risk of harm. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed so that their needs are known and can be met. Evidence: People are assessed before they are offered a place in the home. The assessment is undertaken by staff who are experienced and competent in assessing peoples needs. Information is gained from care managers,discharging hospitals and the persons relative or representative to make sure all necessary information is gained. Prospective residents are invited to spend some time at the home before a decision is made about if the home is suitable for them. Information is provided in service user guide and homes brochure .This information is available in large print and in different languages, this helps to inform people of the services the home can offer people. Care Homes for Older People Page 11 of 31 Evidence: A place is only offered to people if staff can meet the persons needs.People are invited to look round the home. Trial visits are also offered to allow people who have dementia time to be able to experience what it would be like to live in the home. This also allows staff a chance to find out how people may settle into the homes environment and to see how they can meet the individuals needs. Care Homes for Older People Page 12 of 31 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health care needs are known and are being met. However some documentation required reviewing or updating to make sure peoples health and wellbeing was being monitored effectively. Evidence: Care plans are personalised and clearly identify how people can be helped and supported. People are prompted and encouraged by the staff to maintain their independence wherever possible. Risk assessmants are in place to make sure that staff are aware of the risks people may not recognise so that staff can help protect people from possible harm. However one out of the four case tracked people had not had their care plans updated for some months, this was discussed with staff, who immediately commenced reviewing the persons file to make sure their needs were still being met. One person living in the home said they were treated with dignity and respect by the staff, they said staff listened to them and acted upon what they said. This was also Care Homes for Older People Page 13 of 31 Evidence: confirmed by speaking with two relatives. Staff working on all the units were seen to be attentive and patient when helping people who required assistance. They knew peoples needs well and in some cases staff stepped in to avoid situations occurring and prevent people from getting anxious or provided what the person required for them to feel settled and comfortable. People who require input from other health care professionals such as general practitioners, district nurses and community psychiatric nurses receive the help and support they need to help maintain their health and well being. Specialist equipment is available in the home to help staff meet peoples individual care needs. Medication systems operating in each area of the home are mainly robust. An audit of the medication systems is regularly undertaken and shortfalls are addressed. On some of the units medications being returned to pharmacy were checked by one member of staff, it was suggested that for safety two people should check the returns and sign the documentation.On Rosedale the medication fridge was not locked although the treatment room door was secure.One person had a medication prescribed and a signature was missing for one dose on one day. Staff did not know if this medication had been refused as this had not been indicated. Staff should make sure that if medication is not given the reason for this is recorded on the medication administration record so that there is a clear record of medication being taken, to be able to monitor peoples health and wellbeing. Care Homes for Older People Page 14 of 31 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive social stimulation that is provided by staff who have training in dementia needs. People receive a nutritious diet, food is offered every two hours, and throughout the night, to make sure peoples nutritional needs are being met. Evidence: There is an activities co-ordinator on every unit now to help provide social stimulation to people in one to one activities or in small groups. Care staff also spend time with individuals and are skilled at carrying out 30 second activity techniques for people who have a very short span of attention, for example to give someone a picture book and talk to the person about a photograph which can stimulate the persons memory. One inspector spent 2 hours in the afternoon in the communal lounge on Ribblesdale. A Short Observational Framework Inspection (SOFI) observation was carried out by one inspector on 5 people living on this unit. An activities co-ordinator was on duty and she and the other care staff on the unit were engaging individuals in brief activities or lengthier conversations. Some people needed more stimulation to engage in social skills,each person received staff contact, no-one was being ignored. Peoples privacy and dignity was well maintained during this observation.Staff interactions were Care Homes for Older People Page 15 of 31 Evidence: very good. They were around in the communal area, engaging with individuals for brief moments of activity.There were books around, with colour photographs, eg, one man was looking at a book about Yorkshire, illustrated with photographs of landmarks and the countryside, which staff were talking to him about. Staff also tried small jigsaws with some people. The activities co-ordinator was very skilled at engaging people with the picture books. For example, one lady looking at a book of old photographs of people in Edwardian dress was being asked about hats Point to the one you like best. The activities co-ordinator demonstrated good communication skills with different people, this helped people to reminisce and enjoy the time she spent with them. Peoples religious faith is acknowledged and peoples individual religious needs are being met. Church services are held at the home for people to attend if they wish. Visiting is open and people can go out with their relatives if they want to. Staff take people out on trips, and there was a trip to a local old-fashioned cinema to see a film which people really enjoyed. There is also a Sweetie Man who comes to the home and takes a mobile old fashioned sweet trolley round all the units so people can choose their favourite sweets from the past. Staff have had training from the Alzheimers Society, in Nutrition and Meaningful Activities.This makes sure that staffs skills are up to date and relevant to the people they are looking after. Food prepared is appetising and nutritious. People have a choice of what they would like to eat. To help people to remember what the food looks like pictures are available to help stimulate peoples appetite. Special diets and finger foods are provided. There is something to eat available every two hours so that people who expend a lot of energy do not become undernourished. There is also a Nite Bite menu available, again this shows people pictures of the food that is available to them to help people to choose what they might like to eat. There is a hot meal at tea time as well as lunch and people are encouraged not to eat sandwiches all the time, but to try the hot option, and if they are not interested in this staff are skilled at getting people to try different main courses or deserts to make sure people gain the nutrition they need. People who have lost weight are referred to their general practitioner or to the dietitian, and care plans are put in place to make sure that their condition is monitored to prevent a deterioration in peoples health occurring. Mealtimes are protected times so that medication and visitors do not disturb staff from giving people their full assistance to help people eat in an unhurried manner. Staff Care Homes for Older People Page 16 of 31 Evidence: assisting people to eat were sitting either directly in front or to their side, on the same level, which made for good communication. Staff are able to offer people different things if they are not interesting in eating, eg, light desserts, smoothies and drinks. Care Homes for Older People Page 17 of 31 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their concerns looked into and acted upon. People are protected from abuse by well trained staff. Evidence: Relatives spoken with and one person living in the home said that they knew how to raise issues they may have with the staff or manager. There is a complaints policy in place which people have access to.Complaints received since the last inspection were looked at and the issues raised had been dealt with. People had been spoken with to let them know the outcome of the issue that had been raised and people were happy with this process. A lot of commendations were seen and these are shared with the staff to help staff feel they are appreciated. Staff receive training about how to safeguard people during their induction and at regular intervals thereafter, they are skilled in being able to defuse tensions between people living in the home when this occurred. Staff spoken with knew what to do to protect people from abuse. There is a zero tolerance policy in place regarding abuse, and a whistle blowing policy in place. Staff receive training in how to switch so that if a person is upset with a member of staff another staff member steps into help defuse tension, this was seen to work well during the site visit. Management report any issues promptly so that they can be dealt with appropriately. Care Homes for Older People Page 18 of 31 Evidence: Other agencies who require to be informed of these issues are notified immediately, this helps to protect people. Care Homes for Older People Page 19 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live on a site where four of the five units require refurbishment, to make the home environment pleasant for people to live in. Evidence: Each unit has a different atmosphere and unique feel to it, all units have a secure door entry system to help keep people safe. Relatives spoken to said they felt the care was good but were desperate to see the non purpose built areas of the home have the refurbishment and redecoration work commenced as quickly as possible. Ribblesdale and Rosedale units are the most in need of refurbishment in their corridor and bathroom areas, this would greatly enhance these uninviting areas that are decorated in a mannor which does not help people with memory issues to find their way around. On Rosedale there was a shower room next to bedroom 4, which smelt very unpleasant. There was damp penetration through the bathroom wall into the corridor and into the adjoining bedroom wall. This issue must be rectified, to make sure the bathroom is pleasant for people to use. All units have memory boxes outside peoples bedrooms. These should be lowered so they can be seen better by people to help them remember which is their bedroom. On Ribblesdale there was an unpleasant Care Homes for Older People Page 20 of 31 Evidence: aroma as soon as you entered the unit, this should be adressed, to make sure the unit is inviting for people. There is visiting parking available and all units have an area of garden that is enclosed for people to be able to use. Wharfdales garden however does not have even flagstones so this could cause people to fall, and this must be addressed. A bus stop has been created and there is a small cafe in the grounds which is used once a week by visitors, staff and residents. There is some reminiscent material on the walls, however the cafe should be made more inviting for people to use. The laundry was inspected. Infection control measures are in place for handling soiled linen. Hand wash facilities are available for staff throughout the home except for some small treatment rooms where hand sanitizer is available. This helps maintain infection control. Care Homes for Older People Page 21 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are looked after by adequate numbers of well trained staff. Evidence: Staff are efficient and effective and are attentive to people living on all units of the home.The staffing levels provided on the days of the site visit were adequate to meet peoples needs. Staff spoken with were happy with the staffing levels and they felt that the management team helped and supported them in their work. Staff are recruited using robust methods, all necessary pre employment checks are undertaken and staff do not start at the home without the results of these checks being known, this helps to protect people. New staff receive induction training and this helps them to understand what is required of them and gives them the skills they need to be able to give good care. A training record is kept for each member of staff, as well as a training programme for the year to make sure moving and handling, fire, infection control and training in all other relevant subjects is provided regularly for all staff,so thay can meet peoples needs. Staff are invited to attend meetings where they can give their views, those not able to Care Homes for Older People Page 22 of 31 Evidence: attend can read the minutes. The management staff have an open door policy and staff can speak with them at any time, to raise any issues, this helps staff to feel valued. Care Homes for Older People Page 23 of 31 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is managed effectively, however peoples health and safety may be compromised by the inappropriate storage of toiletries and lack of action when observing issues which may place peoples health and safety at risk. Evidence: The manager and clinical services manager have an open door policy so that people can speak with them at any time. They start work at 8.00am so that the night staff can come and speak with them if they wish. The manager is supported by unit managers and the clinical service manager. The operations manager also visits the home regularly to see how the home is being managed. BUPA have an estate departments and hotel services departments, so that the manager can gain help and advice as required. There are comprehensive policies and procedures in place to help make sure the home runs effectively.Meetings are held on all units to find out peoples view of the service they are receiving, and to ask for peoples suggestions about how the services being provided can be improved. Yearly questionnaires are completed by Care Homes for Older People Page 24 of 31 Evidence: people living at the home and by their relatives, these are sent to head office to be collated before the results of these surveys are made known to the home. An action plan is commenced to address any issues found. Personal allowance accounts are in operation for people living at the home.These accounts are audited to make sure people are protected from financial abuse. During the inspection it was discovered whilst looking at staff training that staff supervision and appraisals were not up to date or being undertaken on 4 out of 5 units. This should be addressed to make sure that staff are practicing their skills safely and to make to make sure staff can raise any training needs they may have to help staff keep their skills up to date. Health and safety auditing takes place on a regular basis and general maintenance also occurs, and equipment being used is serviced and maintained. However health and safety issues must be dealt with quickly by staff to make sure people are not placed at risk of harm. For example on Littendale a set of step ladders had been left in a linen cupboard, the door of the cupboard was open, the ladders were unattended and this could have posed a hazard for people living on this unit. Also on this unit there were raised screw heads on bedroom doors, where fire signs had been removed. Some people who may run their hands over these surfaces could catch their hands on these raised screw heads. On Wharfedale upstairs a corner of plaster was exposed and this revealed a metal trellis under the plaster which was sticking out enough for people to get their legs caught on it. On Wensleydale, during a second visit to this unit a door alarm which had been fine earlier had the wires pulled half out of the alarm unit and two wires were exposed and pointing into the corridor. One bathroom curtain rail was also hanging down. There was a more serious concern on Rosedale in the shower room a used dining plate was found above the toilet with a serviette, there was an open bottle of strawberry bubble bath with the top off,this product may be confusing for people who may think due to its pleasant aroma and colour that it could be a fruit drink.On Rosedale and Littendale communal toiletrys were found not secured in peoples wardrobes. Communal hairbrushes were also found in 2 bathrooms on Littendale on the second day of the site visit. On Wensleydale the staff left the kitchen area and did not check the door had closed and locked behind them, staff were reminded to do this. These issues were seen and acted upon when the inspectors requested action to be taken, however all of these issues could have been observed and dealt with by the staff working on each separate unit, to make sure that peoples health and safety was being protected at all times. The bathrooms were not homely apart from on Littendale. Some bathrooms had manual bath hoists in place, wherever possible these should be replaced for to help Care Homes for Older People Page 25 of 31 Evidence: protect the health and safety of the staff who use them. A yellow clinical waste bin for Wensleydale was overflowing, and the lid could not be closed, clinical waste should be stored securely to prevent cross contamination from taking place. Care Homes for Older People Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 The flagstones in Wharfedale 18/05/2009 garden must be made level. So that people at not placed at risk of falls. 2 19 23 The shower room on Rosedale which is next to beroom 4 must have the damp problem rectified so that the corridor wall and adjoining bedroom walls are not damp. To make sure that these areas are pleasant for people who live in the home. 18/05/2009 3 38 13 Personal toiletries and 17/04/2009 strawberry bubble bath must not be kept in communal bathrooms. To prevent people from using these products inappropriatly, which may place peoples health and safety at risk. Care Homes for Older People Page 28 of 31 4 38 13 Clinical bins must have all clinical waste securely contained within them. To make sure that infection control is maintained. 17/04/2009 5 38 13 Screws which are left in 17/04/2009 place after fire warning signs have been removed from bedroom doors on Littendale, must be removed. On Wharfdale the metal trellis sticking out of the plaster upstairs must be repaired. On Wensleydale the bathroom curtain track hanging down on one side must be repaired. To make sure that peoples health and safety is protected. 6 38 13 Satellite kitchen doors on individual units must be securely locked when staff are not present. In the main kitchen the floor covering must be repaired to make sure that it is secure to the wall. To make sure that people cannot gain entry and be placed at risk from scalding. And to make sure the kitchen floor covering can be cleaned effectively to 17/04/2009 Care Homes for Older People Page 29 of 31 maintain food hygiene standards. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 People should have their care plans reviewed at least monthly so that their needs are known and their current needs are being met. Medications that are being returned should be checked and signed by two members of staff, to make sure that the return system helps to protect the staff. Medication not given or being refused by people should be recorded on the medication administration record(MAR), so that there is an accurate record available for monitoring peoples health and wellbeing. 2 9 3 4 19 19 The cafe should be improved to make it more pleasant for people to use. The planned programme of refurbishment should be undertaken, this is especially needed in the corridors and bathrooms on Rosedale and Ribblesdale, to make sure the home is pleasant for people to live in. The memory boxes should be lowered outside peoples bedroom doors so they can be seen better by people, to help them remeber which is their bedroom. 5 26 The source of the unpleasant aroma in the entrance of Ribblesdale should be found and action should be taken to make sure that the unit smells nice for people. Bathrooms should be made homely for people to use, manual bath hoists should be replaced wherever possible with hydraulic bath hoists which would help to protect the health and safety of all parties. Staff should be vigilant when working in the home and report any health and safety issues immediately so they can be rectified, to make sure peoples health and safety is protected. 6 38 7 38 Care Homes for Older People Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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