Inspection on 06/07/06 for The Flowers

This inspection was carried out on 6th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Flowers 24/06/08

The Flowers 03/07/07

The Flowers 21/02/06

The Flowers 08/12/04

The Flowers 14/06/04

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

CARE HOMES FOR OLDER PEOPLE The Flowers 3 Snape Drive Horton Bank Top Bradford West Yorkshire BD7 4LZ Lead Inspector Susan Knox Key Unannounced Inspection 6th July 2006 9:00 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 The Flowers DS0000001161.V301313.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. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Flowers Address 3 Snape Drive Horton Bank Top Bradford West Yorkshire BD7 4LZ 01274 575814 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) flowerscarehome@aol.com Mrs Catherine Ruth Taylor Mrs Catherine Ruth Taylor Care Home 23 Category(ies) of Dementia - over 65 years of age (23) registration, with number of places The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: The Flowers is a detached adapted property located in a residential setting overlooking Horton Park. It is close to local amenities and a city bus route. It provides residential care for those with a mild to moderate dementia and other memory loss disorders who are over pension age. The majority of the twenty-three service users are accommodated in single bedrooms, there are two shared rooms and approximately half have en-suite facilities. There are two communal areas; one is divided into a lounge/dining area with clear views of the garden. The other is a quieter room that provides a calming environment. Residents can easily negotiate the building inside, as there are ramps between the different levels and a passenger lift to aid mobility. In addition there is easy level access to the enclosed garden. To the outside there is a car park close to the building and a secure enclosed garden with a number of sitting areas for residents to enjoy good weather. The current scale of fees ranges from £365 to £475 weekly. Additional charges are for chiropody and hairdressing. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A pre inspection questionnaire was sent to the manager to be completed with up to date information about the home in time for the inspection. This had been returned to the CSCI in time for the inspection. Comment cards were sent to three visiting professionals before the inspection. None were returned in time for this report. One inspector carried out this unannounced key inspection between 09.00am and 5.15pm. The purpose of the inspection was to ensure the home was operating and being managed to a satisfactory standard. During the inspection the inspector spoke to four residents, four staff and the registered manager. Some parts of the building were checked. Records were inspected including care plans, assessments, staff recruitment and training records, accident reports, financial records and health and safety records. Comment cards were also left with the home to be given to service users and sent to relatives. During the visit observations of morning routines including breakfast time showed that care staff were observant of resident’s needs and safety, provided them with choice and respected their privacy. What the service does well: What has improved since the last inspection? The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 6 A new format of care planning has been introduced since the last inspection. As well as addressing the resident’s individual needs it is an easily accessible document for care staff to use. A structured format has been introduced for handing over to different staff on each shift change. The focus is on the health and safety of residents. The manager has introduced a senior care exam before agreeing to care staff with the necessary experience becoming senior carers. 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 Flowers DS0000001161.V301313.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 The Flowers DS0000001161.V301313.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3. Quality in this outcome area is excellent. This judgement has been made following a site visit and checking documentation. The Statement of Purpose/Service User Guide provides sufficient information so that existing and prospective residents are kept fully informed of the service. The manager does ensure residents are fully assessed prior to admission and staff can meet their needs. EVIDENCE: The registered manager confirmed that the Service User guide is given to prospective residents and/or relatives. This is part of the brochure giving information about the home. This was displayed in the home for visitors to see. Contracts of residency were seen in the care documentation for the four residents case-tracked. Relatives had signed these. The name of the room to be occupied was included as required under this standard. In the care documentation for the service user’s case tracked there was evidence that all had been assessed before admission. The manager undertakes these visits. Through case tracking the most recent admissions, The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 9 talking to staff and observing routines it was clear there was an understanding of individual needs. There was evidence in training documents that new staff receive training about giving care to those with dementia in their induction and this is followed by periodic training in house and provided by external agencies. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgment has been made using the available evidence and during a visit to the home. The care-planning format has improved. Potential risks to the health of residents are identified and measures put in place to reduce the risks. Resident’s representatives are given the opportunity to have their say. The procedures for administering medication are good but some adjustments would further enhance the safety of the residents. EVIDENCE: The inspector chose four residents to case track. A new format of care documentation has recently been introduced. This has improved ease of use for the care staff. Due to the new format not all relatives have had the opportunity to sign the care plans to indicate their involvement, although this is evident in the old documentation. The care planning follows on from the initial assessment and addressed individual needs. For example, the nighttime routine was a particular concern for one resident. It was evident from observations, discussions with staff and from the care documentation that the resident’s choice was of paramount importance. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 11 A number of risk assessments had been carried out and were up to date such as moving and handling, continence and skin tissue viability. Where these are found to present a significant risk to health daily monitoring sheets are introduced. Since the last inspection body mapping charts have been included. These help staff to monitor the reasons why residents may have bruising, the cause of which may be unknown and to find ways to reduce reoccurrence. A nutritional care plan has also been recently introduced but the manager was advised that a nutritional risk assessment should be undertaken in the first instance. There should be a procedure for dietary assessment and nutritional screening, with appropriate first line dietary interventions and when and how to refer to a specialist. These were sent later to the CSCI. Monthly weights of individuals is undertaken and recorded. One care plan should have had more detail for staff in how they deal with aggression. The manager said that she had given a training session on the correct approach for one individual. A copy of a care plan was later sent to the CSCI detailing how staff would use distraction and avoid confrontation in dealing with aggression. From discussions with staff and the documentation it was clear that the health needs of residents was being met. The multi disciplinary records showed the different professionals who are contacted for advice and support with the care of individuals. For example, the manager was waiting for confirmation from the community nursing team that they can provide support to someone readmitted from hospital. The medication records and storage were checked. A monitored dosage system (MDS) is in place. A drug trolley is used and taken into the dining room in order to dispense medication. A locked storage area is available for storing the trolley when not in use. The recording of the administration of medication was satisfactory. Stock control checks can be carried out as the amount of tablets brought into the home is recorded. Three resident’s medication was checked including controlled drugs and antibiotics. The number of tablets was correct and tallied with the administration record. The staff were advised to ensure that the date is correctly recorded of medication brought into the home such as antibiotics. The dates on the pre printed Medication Administration Record (MAR) should be altered to reflect this. Instead of day one as the start day, the date should be recorded. Some secondary potting up of medication was seen on the day of the visit. The senior care responsible for medication on the day was honest enough to admit that this had been done for her convenience so that she did not forget those who were still in bed. Secondary potting up (putting tablets into small individual pots from the original packaging) must not happen as this increases the risk of mistakes occurring. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 12 One resident was able to say he was happy with the way medication was given. Staff confirmed that they had had medication training and this was verified in the training records and training certificates. From observations carried out during the visit staff were caring. Interaction between residents and staff was good. Residents looked well cared for. Staff spoke to residents in a positive way giving much encouragement to those who were more independent. Residents were able to move freely about the home. Residents were treated with respect and privacy was provided. Staff were seen to knock on bedroom doors and other doors were locked for privacy as necessary. The Flowers DS0000001161.V301313.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15. Quality in this outcome area is excellent. This judgment has been made using the available evidence and during a visit to the home. The daily living activities ensure that the residents maintain daily routines and events as they would in their own homes. Equality and diversity is addressed. Staff welcome visitors who call at the home. The residents are offered choice of meals. Staff understand the importance of fluid intake for elderly people. Food hygiene training for staff who are food handlers would further ensure the safety of residents. EVIDENCE: There was evidence on display about the daily lives of residents within the home. The daily board gives information about daily events and the staff on duty. Notices were displayed in different places giving the date when a local church was visiting. Photographs of residents celebrating different festivities and outings were available. The hairdresser was visiting on the day of the inspection. Care planning records were person-centred and focused on individual needs including tactile interaction with staff. The manager explained her philosophy about daily living/activities. Rather than group activities, daily living routines are built into each shift such as staff reading items from the newspaper to residents. Residents helping to fold table linen and clear tables. This was observed on the day. In addition, monthly events are organised. Recently there has been a visit to St. Georges Hall, to a The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 14 local pub and fish restaurant. During a reminiscence session a resident confirmed her enjoyment of an occasion when fish and chips were brought into the home. Staff are currently organising memory boxes with the help of residents and relatives. These will contain mementoes and photographs that will help with reminiscence sessions. During the visit the manager arranged a reminiscence session by using old photographs depicting tin baths and old sweet shops. This was done to great effect and created stimulating conversation with the residents. Equality and diversity in the home has been addressed. There are no male carers so the two male maintenance staff have become key workers for the male residents. They spend one to one time with the residents weekly, complete the care plan diary and help with the memory box. In addition because of the resident’s preference one helps with bathing procedures. Audio books are available for those with sight impairment and the deaf society has been involved with someone with hearing needs. The home receives many visitors. One relative has chosen to become a volunteer and visits the home weekly. On the day a relative had called to see a resident who was still in bed. It was apparent that he was comfortable with visiting at any time and felt there was no restriction on entering his relative’s room. The visitor’s book shows the numbers of people visiting. From observations it was apparent that staff attempt to provide choice. They enable residents to retain control of daily living while at the same time recognising where they may be at risk. Some residents were still in bed at the time of arrival at the home and up to lunchtime. Staff confirmed that bedtimes were entirely the resident’s choice. One resident concerned she was moving too slowly was reassured and told to take her time. Positive choices were given for the breakfast meal and additional helpings and drinks given on request. The main meal of the day is in the early evening and a lighter meal is given at lunchtime. On the day of the visit the care staff were preparing and serving the breakfast and mid day meals. Menus were displayed in the kitchen and in the dining room. Choice was available and was offered to residents. It was very clear that staff were aware of the importance of regular fluid intake for elderly people. Jugs of juice were available in different areas and staff responded to requests for hot drinks. Fresh fruit was also available for residents. The cook was attending NVQ training and she had completed a food hygiene course. However, two carers had not had food hygiene training although the manager thought this had been done. This oversight puts residents at risk and should not happen. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 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): 16,18. Quality in this outcome area is good. This judgment has been made using the available evidence and during a visit to the home. An appropriate complaint’s procedure is in place. Service users are safeguarded as staff are trained in how to deal with allegations of abuse. This would be further enhanced if management attended the local authority adult protection-training course. EVIDENCE: The homes complaint procedure was displayed in the hallway readily available for visitors to seer. The procedure is also in the Homes Booklet/Statement of Purpose/Service User guide. The manager is aware that complaints have to be recorded with a report of the action taken to address the complaint. This was available in the complaints book. The last complaint was in March 2006 and was well documented. The last complaint received by the CSCI was in February 2006. In the pre inspection questionnaire the manager said that one had been received and was partially substantiated. This was fully documented and was not about the care of residents. Staff confirmed that the manager has discussed abuse and adult protection with them regularly and this is good practice. In addition, this is included in National Vocational Qualification (NVQ) training, which many have completed. The manager has not attended the Adult Protection training arranged by the local authority. It was agreed that this would be organised. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 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, 26. Quality in this outcome area is excellent. This judgement has been made using available evidence from the site visit that included an inspection of some bedrooms and communal areas. There is a good understanding of infection control procedures. The home provides a homely, clean and very comfortable environment. EVIDENCE: This home provides care for residential service users and the majority are ambulant. There is level access into the home and the garden and nearby parking makes it easy for visitors. This adapted extended cottage type building has been provided with a ramp to ensure easy egress between different levels of the building. There is a passenger lift. The bathrooms and WC’s are fitted with hoists, handgrips and high seats. There is a mobile hoist to use if necessary. A warm friendly environment for residents with dementia is apparent on entering the home. Communal rooms are well furnished and planned to provide comfort, interest and a calming environment. During the visit staff The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 17 were aware that the television was not being watched and asked the residents if they preferred music. Appropriate music was then played. Seating is mainly soft furniture with lots of cushions. Continence aids are discreet. There are a number of reclining easy chairs for relaxing with foot rests. Bookshelves and displays contain items of interest such as dinky cars, soft toys such as teddy bears, books and magazines. The manager is constantly providing different stimulation around the home. Recently this was in the form of a number of ribbons hung down in a doorway that residents walk through. Someone with sight impairment particularly enjoyed this. Decoration creates a calming influence and carpets are plain in order to avoid confusing patterns. The bedrooms viewed on the day were also decorated in calming restful colours and were well furnished. Personal items were seen in bedrooms belonging to service users. The newer bedrooms have en suite facility of washbasin and WC. Those who were able said they were comfortable. During the inspection it was noted that cleanliness was to a very good standard. In two bedrooms there was a problem with odour control that the manager was aware of and was attempting to address. During discussions with staff and from observations it was apparent that they had a good understanding of infection control policies and procedures. Where mistakes were made these were addressed by senior staff. One member of staff was redirected to take damp towels elsewhere rather than through the dining room. Paper towels and liquid soap were available in the laundry, kitchen, bathrooms and WC’s. Some soft towels and bars of soap were seen in communal bathrooms and WC’s this compromised infection control. If residents want to use these they should be brought to communal areas and then returned to bedrooms. The laundry is located on the lower ground floor. This provides two washers and a dryer. The washer conforms to infection control standards and has a high temperature cycle. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 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, 30. The quality of the outcome in this area is good. This judgement was made using available evidence including a site visit when documentation was inspected and discussions held with the staff on duty. The manager has ensured the protection of residents by obtaining CRB and POVA checks of staff working at the home. This would further be enhanced if references from previous care employment were always obtained. Relevant training that matches the needs of the residents is ongoing. EVIDENCE: The home was well staffed on the day of this unannounced inspection. The person in charge early in the day was a senior care who was aware of her responsibilities. A copy of the rota for the week of the inspection was made available and staffing levels were appropriate. National Vocational Qualification (NVQ) training is on going. The requirement is to have 50 of care staff with level 2 or above NVQ qualifications. Currently the home has nine of the staff with NVQ level 2 training or above. This means the home is near to achieving this standard with 47 . Other staff are undertaking this training and others are booked to start the course in September 2006. Staff confirmed NVQ training during discussions and this was also evidenced in certificates of attainment. Recruitment files for the latest four members of staff were checked. Application forms had been completed and two references sent for in all cases tracked. All had received references but in two cases there had been previous employment The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 19 in a care setting but no request made for a reference from there. In order to fully protect the residents, a reference should always be requested from an employer in a care home/agency. In addition, the applicant’s last 10 years of work experience (where applicable) should be ascertained. Criminal Records Bureau (CRB) checks were available. Also copies of the Protection of Vulnerable Adults (POVA) first checks were available in files. Staff terms and conditions were available and there was evidence that staff had received an induction including the philosophy of the home. This documentation ensures that care staff are aware of expectations relating to their care of vulnerable people. Staff terms and conditions were available and also evidence of identity checks, qualifications and courses attended. This is as required. It was evident from the records and in discussions with staff that new staff receive a good induction into working in the home. One could not remember this but agreed her signature was on the induction list. Induction includes health and safety such as fire procedures. In addition it refers to resident’s privacy and independence. Staff confirmed that the induction gave them a good basic understanding of the home’s practices, policies and procedures. As would be expected in a home providing care for those with dementia there is an emphasis on staff receiving dementia training. There is in house training such as the six-week foundation course in person-centred care and ‘Insight into Dementia Care’. In addition the Alzheimer’s Society has provided training. Certificates were available. During discussions with staff it was confirmed that other training was ongoing such as moving and handling, food hygiene, dealing with aggression and diabetes. Others such as infection control are planned. Discussions about abuse and the protection of vulnerable adults had been attended. It was evident that training is encouraged in order to fully meet the needs of residents and protect them. The maintenance staff responsible for fire safety confirmed that fire lectures had been given to staff. These records were available. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 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, 33, 35, 36, 38. Quality in this outcome area is good. This judgement has been made using available evidence including the site visit, pre-inspection questionnaire (PIQ) and discussions and observations. The manager effectively manages the home for the benefit of residents. Improved QA systems are required so that the outcomes for residents can be measured effectively. EVIDENCE: The registered manager has been in post for many years. She is a Registered General Nurse who has confirmed that she has an active registration. She also has a teaching qualification City and Guilds 730. She has had many years of experience in managing care homes. Some personnel changes since the last inspection have affected her plans for the Registered Manager Award (RMA). This has still to be resolved. Staff and residents spoke well about her management qualities. Due to the mental health needs of many residents meetings are difficult to hold. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 21 Therefore, every month each resident is asked individually about their preferences and if they have any concerns. Minutes of these discussions are made and a staff meeting follows on. In addition, senior care meetings are also held. Records were available for inspection. Where necessary relatives are informed by letter or in person about individuals. A recent letter was received from a relative and although it was about a concern it also thanked staff for ‘the care and love they gave to residents’. Quality assurance (QA) within the home was discussed and although resident and relative surveys have been done in the past QA systems must be improved. Systems must be introduced that will measure outcomes for residents in all levels of care within the home. The manager was able to show computer records of resident’s monies. A small amount of money is left with the home for resident’s requirements. Invoices were available of fees paid on behalf of residents. The manager said that relatives also receive a copy of personal allowances records with their invoices. The manager has undertaken appraisal/supervision training and regular supervision of care staff is ongoing. These records were available for inspection. The records for fire safety checks were checked. The fire alarm and emergency light testing is carried out weekly. Staff fire drills are held. These were recorded with the names of those staff that attended. Staff confirmed this during discussions. Health and safety within the home was well maintained with some omissions. The manager said that maintenance staff were undertaking long distance training in health and safety. Maintenance records were seen and were up to date. Outstanding were records related to an electrical wiring certificate and Portable Appliance Testing (PAT). Copies of these checks were later submitted to the CSCI. The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 3 The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Timescale for action 18/08/06 2. OP9 13 3. OP18 12, 4 OP29 19 5 6. OP31 9 12, OP38 Care planning should include more detail about how staff care for those with aggression. Ensure that a recognised nutritional assessment tool is in use and part of the care plan. Secondary potting up of medication should not be carried out. Ensure that the date is recorded when medication is started. 13, 17 The registered manager to make a booking to attend the local authority adult protection training to ensure a robust approach is taken to allegations of abuse. Ensure that where possible references for new staff are obtained from care agency employers. The registered manager must have the RMA qualification or equivalent. 13, 16 Ensure that food handlers attend food hygiene training. Ensure that soft towels and bars of soap are kept in individual bedrooms rather than communal DS0000001161.V301313.R01.S.doc 18/08/06 18/08/06 18/08/06 31/12/06 18/08/06 The Flowers Version 5.2 Page 24 bathrooms and WC’s. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 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 © 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 The Flowers DS0000001161.V301313.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!