Inspection on 06/01/06 for The Gables Nursing Home

This inspection was carried out on 6th January 2006.

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

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

Other inspections for this house

The Gables Nursing Home 07/11/08

The Gables Nursing Home 23/04/08

The Gables Nursing Home 30/04/07

The Gables Nursing Home 11/10/06

The Gables Nursing Home 11/07/06

The Gables Nursing Home 13/07/05

The Gables Nursing Home 21/12/04

The Gables Nursing Home 19/04/04

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

CARE HOMES FOR OLDER PEOPLE The Gables Nursing Home 231 Swinnow Road Pudsey Leeds Yorkshire LS28 9AP Lead Inspector Sean Cassidy Unannounced Inspection 6th January 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 The Gables Nursing Home DS0000001338.V275878.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. The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Gables Nursing Home Address 231 Swinnow Road Pudsey Leeds Yorkshire LS28 9AP 0113 2570123 0113 2558644 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) Dr Hussan Ara Minhas Dr Emad-Ul-Mulk Minhas Mr Kevin Joseph Brennan Care Home 23 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (3), Old age, not falling within any other of places category (23), Physical disability (1) The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The place for Physical Disability is specifically for the service user named in the variation application dated 20 February 2004. Not to exceed 3 service users in total for the categories DE and DE(E) Date of last inspection 13th July 2005 Brief Description of the Service: The Gables Nursing Home is a converted building, which has been extended over the years. The home is situated on a busy main road equidistant from Leeds and Bradford with good access to public transport. The home is next to a public house and close to other amenities, including shops and a post office. Pudsey cricket ground is to the rear of the home and some of the bedrooms enjoy views over the ground. The Gables Surgery is situated within the grounds. The home provides personal care with nursing for both men and women, over the age of 65. The majority of rooms are for single occupancy with some shared rooms available. There are some en-suite facilities, the majority of which have limited access. The lounges and dining rooms are situated on the ground floor. There is limited access to the grounds by means of a re-moveable ramp from one of the lounges. The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector and lasted a full day. The purpose of this inspection was to ensure the home was operating and being managed to a satisfactory standard for the benefit of the residents. The methods used in this inspection included discussions with visitors and staff, examination of records including service users care plans and staff files, a tour of the home and indirect observation of care practices. A number of documents were examined which included care plans, staff files and training files. A three-hour feedback was also provided to the providers and the registered manager at a later date. What the service does well: What has improved since the last inspection? Prospective residents and their families are sent all the necessary documentation needed to assist them with their choice of moving in. Improvement has been made regarding referring residents to other health professionals. The Commission are notified when untoward incidents occur in the home. The dining facilities are used by larger numbers of residents. The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 6 What they could do better: • • The registered person must refrain from admitting residents outside of the care home’s registration. Improvements must be made to ensure the home can meet the specialist dementia needs of the residents. Recognised training must be provided and the environment reviewed so that alterations can be made to assist those with dementia. Care plans must show that residents or their representatives have been involved in developing this documentation. Residents must be referred to relevant health care professionals when the need arises. Care staff must receive training in the proper use of pressure relieving equipment. The registered person must ensure that the care staff are made more aware of promoting the privacy and dignity of service users. Appropriate locks should be fitted to residents’ doors. Improvements must be made with the provision of activities to residents in the home. Special attention must be given to those residents with dementia. All staff must receive recognised training in Adult Protection. The home must examine the environment and identify ways in which it can be altered to assist service users with dementia. Equipment used for moving and handling should be in good working order. Suitable numbers of assisted baths should be provided to ensure residents’ care needs are properly met. The registered person must ensure the correct checks are made so that carers are eligible to work in the care home. • • • • • • • • • The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 7 • • • The home must ensure suitable numbers of trained and competent staff are on duty to meet all the care needs of the residents. The home must endeavour to identify suitable storage space for equipment when it is not being used. The home has to review the process adopted to deal with specific residents’ monies. Appointees must be arranged to ensure persons working at the home do not act as agents for residents. The home must improve the way it stores personal information kept relating residents. Improvements need to be made to ensure the residents Health and Safety is properly protected. Care staff should be encouraged to become more familiar with the prescribed care in the care plans. Residents’ food likes and dislikes should be incorporated into the menus when they are being developed. Improvements are needed to ensure 50 of the care staff are trained to NVQ level 2 standard. Residents personal monies should not be used by the home to purchase or pay for any goods or services. • • • • • • 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 Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4. The Statement of Purpose and Service User Guide are made available to prospective residents and their families prior to choosing a room. Although the home do assess prospective residents prior to admission, they are continuing to admit people outside of their registration certificate. The home does not provide evidenced based specialist care to people with dementia. Some relatives were not confident in the staffs’ ability to meet the residents’ specialist needs. EVIDENCE: The home has developed a service user Guide and Statement of Purpose. Both documents contain the necessary required information. Relatives spoken to stated that they did receive this information prior to choosing a place in the home. Due to the nature of the residents’ condition it was difficult to ascertain The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 10 whether they received a copy of the Service User Guide. Terms and conditions are now provided prior to moving into the home. The two most recent admissions had been assessed prior to being offered a place within the home. The home has a significant number of residents with dementia and they are only registered to have three persons with that specialist need. But, a recent admission showed that residents with dementia as their primary need continue to be admitted. Two relatives were surprised to learn that the care home was not specifically for people with dementia. Relatives spoke well of the carers and said they tried hard. However, some did express concerns about the carers level of understanding of the residents’ Dementia needs. One relative said, “ They do seem to be very busy doing other things and don’t seem to just sit down and talk to the residents.” After discussions with relatives and staff and also close examination of the care files and the home environment I could not identify the care provided was based on current good practice in specialist Dementia care and reflected relevant and specialist clinical guidance. The staff spoken to could not highlight that they had received recognised training in Dementia or other areas of care relevant to older people. The Gables Nursing Home DS0000001338.V275878.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): 7,8,9,10 Not all care staff are aware of the prescribed care for residents and residents are not yet involved with the care planning process and its review. Some improvement has been made with ensuring service users’ care needs are fully met, but more input is needed. Residents are assessed to self medicate during their stay. There are issues with regards to privacy and dignity that need to be addressed to ensure they are respected appropriately. EVIDENCE: The care plans of four residents were examined. The prescribed care written by the qualified staff was of a good level. However, the care staff spoken to were unaware of the information and instructions contained within these documents when questioned. Although they do sometimes write a record in the back of the folder they do not have an awareness of the prescribed care. The resident that was recently admitted showed evidence of involvement with the plan of care and the risk assessments, but the others did not. The care plans are not reviewed as regularly as they should, which means the care provided to service users may be inappropriate or not provided. The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 12 The residents’ files showed that they are thoroughly risk assessed in many areas such as nutrition, skin integrity, falls and moving and handling. Weights are being recorded regularly and a referral is now made to relevant health professionals when required. Four residents were seen by a dietician for recent weight loss and care plans were developed. One lady identified from the last inspection as needing a referral to a physiotherapist had this carried out.. The manager keeps a regular check on those residents who are beginning to show signs of nutritional deficit. The care plans and risk assessments for pressure area care and wound care were not of a good standard. One residents care files showed her wounds were not being redressed at the times recommended on the care plan. The risk assessment of her pressure areas were not reviewed as regularly as they should have been and as a result her skin condition deteriorated. One pressure area risk assessments was written and signed for a date that had not yet arrived. The records kept regarding wound care plans were poor and did not give a clear picture regarding the resident’s skin integrity. It was recommended to the person in charge that they refer one resident to the Tissue Viability Nurse for advice. Staff are unable to use pressure relieving equipment correctly. The medication records were examined and they showed no omissions. On the day of the inspection It was noted that medications prescribed for 9am had not given at 10.30am. The registered nurse must ensure the medications are given at the prescribed times to ensure the recipient receives the correct effect. The care files showed evidence that residents are risk assessed as to whether they can self medicate whist in the home. Some relatives raised concerns with the issue of dignity within the home. “When I asked the staff if they could take mum to the toilet I was told that she had just been to the toilet fifteen minutes ago and that they would be doing a toilet run soon. This isn’t acceptable” “ I have often seen residents in states of undress that isn’t right.” “ I have seen other residents wearing mum’s clothes.” Locks on resident bedroom doors have still not been installed and therefore compromises residents privacy and dignity. The Gables Nursing Home DS0000001338.V275878.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): 12,14,15. Resident’s routines are not flexible and suitable to their individual specialist needs. Little evidence was seen to show the home helps residents to exercise their choice and have control over their lives. The food appears wholesome and nutritious. The cook could examine the menu to ensure residents with dementia are offered more foods that are easier to eat e.g. finger foods. EVIDENCE: The manager said that all the people living in the home suffer with dementia. There was very little evidence found during the inspection to suggest that the home takes these specialist needs into consideration when they are planning activities or events. The care provided is very much based around physical needs as opposed to being based around Person Centred Care. Carers record in the files what that person has done for the day, but it is by no means structured. There were no activities seen during the course of the inspection and there were none on display. Residents were sat around three different dining rooms with a T.V on and no other interaction seen. Relatives spoken to stated that this was the normal routine. The manager said that a new activities The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 14 coordinator will be hoping to base activities around the dementia needs so that the residents lives can be enhanced. Relatives spoken to were able to give positive feedback regarding visiting times. They felt the staff were welcoming and pleasant. Service users were assisted to use the dining room to eat their breakfast and lunch. The food served for lunch appeared wholesome and appetising. Carers assisted those residents who were unable to feed themselves and this was carried out in an unrushed manner. The menus were displayed in the dining room but they were written in a very small format and out of the way that was difficult for anyone to notice. Some relatives expressed concerns about the residents getting the correct amounts of food as they often noticed meals being put before residents and taken away untouched. Special foods are not prepared for the carers with dementia. Hot and cold drinks were provided regularly throughout the day and relatives confirmed this was normal practice. The resident group living at the home have a limited capacity to express their views and make their choices known with regards to exercising their personal autonomy and choice within the home. Little evidence was seen to show how the home promotes these rights. Relatives spoken to said they are informed when accidents occur. Visiting times are flexible and residents are encouraged to bring in their personal possessions where possible. The Gables Nursing Home DS0000001338.V275878.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): 18 Not all staff are aware of what constitutes abuse or what the procedures for the home are when it is apparent abuse has occurred. Residents need more protection in this area. EVIDENCE: The inspector spoke to members of staff regarding issues of abuse. Not all were familiar with what constitutes abuse and how they should deal with it if they came upon it. They were unable to confirm that they had received recognised abuse training. The training records for Adult Abuse training were seen. Only one member of the care staff on duty that day had received recognised training in this area. The manager is hoping to become an accredited trainer in Adult Protection. The Gables Nursing Home DS0000001338.V275878.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): 19,22,26. The layout of the home is suitable for Older People requiring nursing care but the restrictions regarding availability of space pose problems for residents with specialist Dementia needs. Appropriate equipment was not available to ensure residents’ independence is maximised. The home is clean and hygienic. EVIDENCE: This is a care home for Older People with only registration for 3 residents with Dementia. The manager confirmed that all residents have dementia and well over three have Dementia as a primary care need. This home poses difficulties for people with dementia due to the restrictive environmental layout. It is very restrictive with regards to space and there is very little space for those residents with dementia to wander. Specific adaptations and signs have not been introduced to assist those people with dementia. The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 17 It has a very cluttered feel to it, as storage space is very restricted. The lounge at the side of the house is the area where most people are taken to sit. On the day of the inspection this room was very cluttered and restricted with tables, stools and Zimmer frames. The home does have a maintenance programme for redecoration. Relatives spoken to gave different opinions on the furnishings and décor of the home. One relative said that she was happy with it and felt her father would be happy if he could comment. Two relatives thought the home was “shabby” and in need of refurbishment. The home is normally able to provide suitable assisted bathing facilities but one was broken on the day of the inspection. The maintenance man said that they were waiting for a part to arrive. The side bath panel had been removed leaving residents exposed to the electrics. The maintenance man was asked to replace instantly, which he did. There is a lift, which is used to take residents to the first floor when needed. Not all residents requiring nursing care are nursed on adjustable beds. One of the hoists used by the home had broken leaving only one usable hoist for the home. Little information could be given with regards to the plans to repair the hoist. This meant that the manual handling equipment available to assist residents was reduced. The premises are clean and tidy and kept free from offensive odours. There are good levels of domestic staff available to ensure this standard is maintained. The Gables Nursing Home DS0000001338.V275878.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, 29,30. The staffing levels of the home are not ensuring all the care needs of the residents are being met. The home could do more to ensure residents are in safe hands at all times. EVIDENCE: The staff rota was examined and the numbers of staff on duty matched the rota. Suitable numbers of domestic staff are also employed. Relatives spoken to expressed concerns at the levels of the staff working at the home. Although they felt the staff were pleasant and approachable they said, “ they did not have enough time to sit down and have proper conversations with the residents.” “ They are too busy doing other things which stops them interacting with the residents.” Not all staff are trained to NVQ level 2 standard. The recruitment file of a new member of staff showed evidence that the necessary checks needed to protect the residents in the home were not carried out prior to employment commencing. All new members of staff stated they have received an induction, which they said was helpful. The training records were reviewed and they showed training in mandatory areas is the focus. Staff have not received training in the specialist care needs of the resident group e.g. continence, mobility, diabetes, communication, dementia. The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 19 The Gables Nursing Home DS0000001338.V275878.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): 33,35,37,38 The manager uses quality assurance tools to assist improving care provision in the home. The financial procedures adopted by the home do not fully safeguard the interests of service users. The rights and best interests of residents could be improved by ensuring personal records are kept securely. Improvements could be made to improve the health, safety and welfare of the residents living in the home. EVIDENCE: The manager has introduced a system that enables him to identify areas within the home that are in need of improvement. The complaints records, accident The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 21 records and questionnaires are also used to assist this quality assurance system. Regular staff meetings and resident/relative meetings are held to discuss relevant topics. The financial records of the residents were inspected. The administrator said that she managed the finances of three residents for the home. She had tried in vain to get an appointee arranged for these individual and therefore has had to continue with the role. The records kept regarding monies and receipts are good. However, it was identified that one resident’s personal monies were used as a home float as the providers do not always make sufficient monies available. Groceries and other accessories are purchased with this money. This must cease. Care plans containing personal and confidential details of residents are not properly secured. There were a number of health and safety issues identified during the inspection. All carers have not received the recognised training in areas such as Moving and Handling and Fire training; Electrical equipment used by the residents and staff is not correctly PAT tested; fire doors are propped open using wedges; fire escape blocked by wheelchairs. The Gables Nursing Home DS0000001338.V275878.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 3 x 2 1 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 1 14 x 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 2 2 x x 2 x x x 3 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 2 x 2 1 The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2 Standard OP3 OP4 Regulation 14 18 Requirement The registered persons must not admit residents outside of their registration. The registered person must ensure the staff individually and collectively have the skills and experience to deliver specialist dementia care to residents. Care plans must be drawn up with the involvement of the resident or their representative. (The previous timescale of 30/09/05 was not met.) Equipment necessary for the treatment of tissue viability must be provided by the home when needed and staff must understand how to use it correctly. (The previous timescale of 31/08/05 was not met.) The registered person must enable residents to access other members of the multidisciplinary team when there is a need. This refers to the tissue viability nurse. The registered person must ensure residents’ dignity and DS0000001338.V275878.R01.S.doc Timescale for action 31/01/06 30/04/06 3. OP7 15 28/02/06 4. OP8 16 31/01/06 5. OP8 12 31/01/06 6. OP10 12 31/01/06 The Gables Nursing Home Version 5.1 Page 24 7. OP12 16 8. OP14 12 9. 10. OP18 OP19 13 23 11. 12. OP22 OP22 23 13 13. OP27 18 14. OP29 19 & Sch 2 privacy is repected. Doors to service users accommodation must be fitted with suitable locks and accessible to staff in an emergency. (The previous timescale of 30/08/05 has not been met.) The registered person must ensure suitable activities are provided to residents both inside and outside the home. These must be flexible and varied so to meet resident’s expectations, preferences and capacity. ( The previous timescale of 30/09/05 was not met.) The registered person must conduct the home to maximise residents’ capacity to exercise personal autonomy and choice. The registered person must ensure staff receive recognised Adult Protection training. The home must only admit service users whose needs they can meet, as set out in the home’s Statement of Purpose and Registration Certificate. The registered person must provide suitable storage space wherever possible. The registered person must ensure that equipment needed for the safe system of moving and handling is in a good state of repair. This also refers to ensuring assisted baths are in good working order. The registered person must ensure that the correct amount of suitably trained staff are on duty at all times to ensure the health and welfare needs of the residents are met at all times. The registered person must operate a thorough recruitment process that protects residents. DS0000001338.V275878.R01.S.doc 28/02/06 31/03/06 31/03/06 31/01/06 31/03/06 31/01/06 31/03/06 30/08/05 The Gables Nursing Home Version 5.1 Page 25 15. OP30 18 16. OP35 20 17. 18. OP37 OP38 17 12 (The previous timescale of 30/08/05 was not met.) The registered person must ensure staff receive training appropriate to the work they perform. The registered person must ensure that persons working at the care home do not act as the agent for the service user. The registered person must ensure care plans are securely stored. The registered person must ensure that the health and safety of residents and staff is protected at all times. (The previous timescale of 30/08/05 was not met.) 31/03/06 31/01/06 31/01/06 30/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 .3 4 Refer to Standard OP2 OP15 OP28 OP37 Good Practice Recommendations It is recommended that all care staff are encouraged to read the resident care plans so that they are aware each persons individual care needs. The registered person should ensure residents choices and preferences are taken into consideration when menus are being developed. 50 of care staff should be trained at NVQ Level 2 or above by April 2005. The home should cease the practice of using resident’s personal monies for the home’s personal use. The Gables Nursing Home DS0000001338.V275878.R01.S.doc Version 5.1 Page 26 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. 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