Inspection on 09/05/05 for The Garden House

This inspection was carried out on 9th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Garden House 06/02/07

The Garden House 06/10/05

The Garden House 27/09/04

The Garden House 24/05/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Garden House Cote Lane Westbury on Trym Bristol BS9 3TW Lead Inspector Sam Fox Unannounced 9 May 2005, 8.30am 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 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 Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Garden House Address Cote Lane Westbury on Trym Bristol BS9 3TW 0117 9494000 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) St Monica Trust Mrs Donna McDermott Care home with nursing 50 Category(ies) of OP Old Age (50) registration, with number of places The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate people over the age of 65 years. The Manager must be registered on parts 1 or 12 of the Nursing and Midwifery Council. Date of last inspection 27 September 2004 Brief Description of the Service: The Garden House is operated by St Monicas Trust, a charitable organisation, and is registered to provide personal and nursing care for up to fifty people who are over 65. As such there is a registered nurse on duty throughout any 24 hour period. In order to qualify for residence individuals need to be baptized into the Church of England or one of the protestant faiths. The home is situated on a 23-acre site of well established parkland on the edge of Durdham Downs in Bristol. Bedrooms are located on the first floor and are seperated in to two distinct areas, the Cedars and the Oaks. The premises was purpose built two years ago and thus is fully accessible for people who have physical disbilities. There are numerous aids and adaptations throughout the building. Each bedroom has an ensuite facility. The communal areas are situated on the ground floor and these include a large dining area, two spacious lounges, a library,computer room and hydrotherapy pool. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit that took place over two days. The purpose of the inspection was to ensure that the environment was clean and well maintained, to spot check key records, including staff training ad recruitment and to consult with residents to ensure that they were satisfied with the service they were receiving. Requirements arising from the last inspection were also followed up. Evidence was gathered primarily through discussion with residents (fourteen of whom were consulted in depth), observation and discussions with the manager. Additional evidence was also gained from records, including care plans and participation in the lunchtime meal. What the service does well: What has improved since the last inspection? Improvements continue to be made to the care planning systems within the home. Residents are fully consulted in this process and their preferences and individual needs are carefully considered. There has been a review of their wishes in the event of their death and this has give them further influence over their future care needs. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 6 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 Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 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 standard(s) 1, 4 & 5 There is comprehensive admissions procedure in place which includes up to date information about the home. This means that prospective new residents can make informed choices about moving there and they can be confident that there will be the resources available to meet with their assessed need. EVIDENCE: A number of these standards were not fully assessed and will be the focus of the next inspection. The Garden House has a completed Statement of Purpose which includes the home’s admissions procedure, complaints policy and the ethos of the home. This meets with requirements of the legislation. In addition to the above each resident receives a service user guide which is written in a more user-friendly format and includes the facilities and services available. Residents explained that once they moved to the home they were given a “welcome” pack which included further information that may be of use to them. These were seen in bedrooms at the time of the visit. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 9 Many residents confirmed that either they or their relatives were able to visit the home prior to making a decision to move there. At the time of this inspection the manager had an appointment to show a prospective new resident the facilities available. As will be noted later in this report the home is purpose built and has a number of aids and adaptations. This enables them to meet many specialist needs. A number of residents spoke about particular medical conditions and disabilities that they were experiencing and it was evident that they were confident that the staff had the expertise to support them and that there were resources available to enable them to maximise their independence. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 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 standard(s) 7, 8, 9, 10 &11 Errors are being made with the administration and recording of medication and these shortfalls have the potential to place residents at risk. Health care needs are monitored effectively and action is taken promptly to address concerns so that residents can be assured that their physical and emotional health needs are met. EVIDENCE: Residents have a care plan that is kept in their bedrooms. These were discussed in detail with two residents. They describe the support needed for emotional, social and physical needs. These enable the home to provide a more consistent service that is tailored to individual need. It was noted that one of the care plans did not include some preferences and some did not accurately reflect actual work practice. The manager said that she and the staff are going to further develop the system. The Garden House operates a key working system through which each resident has a named member of staff who plays more of a central role in co-ordinating the service they received. One resident displayed a good awareness of what they could expect from their key worker and said they thought it was a good The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 11 idea. They also confirmed that there were formal review meetings during which time they discussed their care plans and changed it. Some residents have communication books in their rooms which can be used by family and friends to make comment. All residents spoken with said that they were satisfied with the service they received from the local GP surgery. They explained that the Doctor visited the home twice a week for formal rounds but could be contacted at different times in an emergency. This was confirmed through records, which also showed that residents are supported to see other health professionals, including specialists, chiropodists, dentists and opticians. One person has a pressure sore which they have had for a number of years and which is proving difficult to heal. Personal care plans included waterlow risk assessments – which is a tool used to assess the risk of someone developing pressure sores. These were comprehensive and those residents being assessed at medium to high risk have been provided with specialist pressure relieving mattresses. This as confirmed through observation. In addition to the above each care plan file included a nutritional assessment and manual handling risk assessment. All residents were asked specific questions about their personal care needs and two care plans were discussed at length with the residents to whom they belonged. Without exception, everyone commented positively about the staff team and the sensitive support they were given with their bathing and toiletry needs. They said they felt respected and that they could retain a sense of dignity whilst also receiving support. All confirmed that they could have as many baths as they wished throughout the week, some said they preferred having a shower. A positive development since the last inspection has been the introduction of a proforma about residents wishes in the event of their death. This includes what arrangements they would prefer, who their executor was and who they would like to be contacted. It also explores issues in relation to what kind of medical intervention residents would prefer during certain situations. Whilst this is not legally binding it further extends residents rights to choice and to determine their future care. The Garden House operates a monitored dosage system for the administration of medication that is supplied at regular intervals by the local pharmacist. This was spot checked and found to have the following shortfalls: • There was one incident when tablets had not been given but were signed for as being administered. Version 1.30 Page 12 The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc • • • • • There were at least four occasions when extra tablets had been taken from the monitored dosage system (notably from the end of the month). There was no record as to why this had been done although members of staff said this was because there was a shortfall in prescriptions or that residents had lost tablets. Whilst it is accepted that this may happen on occasion, this should be the exception rather that the rule and there should be records to evidence why this has occurred. It was difficult to effectively audit tablets that are held on the premises which are given on an as and when basis as there was no running monthly stock total. Whilst it is accepted that the home could look at previous administration sheets to check totals, the current system is difficult to monitor by the senior nurses. One lot of PRN medication was spot checked – there was found to be one missing. Currently the home has a limited amount of homely remedies. It was noted that painkillers prescribed for a resident that had since left were being given to other residents. Tablets should only be given to those who they are prescribed for. There was an excess of a controlled pain killing medication on the premises. The medication fridge was not locked and also had food stored in it. Action must be taken by the manager to improve procedures so that residents are not put at risk. This should include a review of the stock control system and regular monitoring by the manager to ensure that adequate standards are being maintained. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 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 standard(s) 12,13 &15 There are effective formal and informal procedures in place for consultation through which residents are offered a wide variety of choices. This means that they can pursue active lifestyles which reflect their interests and preferences and that they do no have to conform to imposed routines. Residents’ benefit from being offered a wide variety of food which is nutritious and wholesome. They can be confident that their preferences and specialist needs will be met. EVIDENCE: Residents said that they felt they were able to determine their own daily routines. They gave examples of this which included getting up and going to bed when they pleased and having the option of meals in their rooms. This was confirmed through observation during the inspection. They also said that whilst there were a lot of activities on offer they did not have to attend unless they chose to do so. There was information about activities available and residents said that there was a popular pottery club, poetry reading and musical events. It was evident from discussion with them that they felt there was plenty to do if they wished to do so. The home also has a computer room and residents said they used The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 14 this to e-mail their friends and to access the Internet. In addition to this there is an extensive library, which also includes videos. Opportunity was taken to join the residents with their lunchtime meal. There were three courses and within this a choice of three main alternatives. Residents explained that they tick a sheet confirming their daily choices. This also included what vegetables they wanted. The meal was wholesome, tasty and well presented. There was a also a wide variety of condiments and sachets of sauces to which residents had unlimited access on their tables. Some residents were observed being discreetly and sensitively assisted to eat their food and the whole meal was served in an unhurried manner. Opportunity was taken to consult with the home’s chef who explained the methods for consulting residents about their preferences. He also had a good knowledge of different dietary requirements, which were based on medical need. He explained that a number of residents required pureed food and showed how the home uses moulds to ensure that this food is presented in a manner which protects the dignity of those eating it. All residents consulted with spoke positively about the quality and quantity of food provided. The majority were also pleased with the amount of choice. Two residents said they would like to be offered a hot alternative for supper. These comments were passed on to the manager who said she would discuss this in the next residents meeting. Nine residents have all their meals in their rooms; it is good practice that residents are able to choose where they want to eat. Three residents said this was important to them as they feel uncomfortable eating around other people. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 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 standard(s) 16, 17 & 18 Residents benefit from living in an environment where their opinions and wishes are actively sought. This means they can be confidant that they will be listened to and that the home will make changes to suit them if they are able. There are effective policies and training procedures in place for the protection of vulnerable adults which have been used to good effect. Residents can therefore be confident that they will be protected from abuse. EVIDENCE: The Garden House has a comprehensive complaints procedure which is displayed prominently on the home’s notice board. All residents consulted with spoke openly and objectively about the service they receive and they said they would speak with the manager if they wished to make a formal complaint. In addition to this they said they attended regular house meetings during which time all issues about the running of the home are discussed with several decisions often being made through a vote. This was further evidenced through minutes. It was clear that this is an active group and that meetings provide an important, more formal forum, through which residents can influence many aspects of the running of the home. The manager records complaints in a logbook. There have been three minor complaints made by residents since the last visit, which have been resolved to residents’ satisfaction. A number of residents confirmed that they had recently voted in the general election and it was apparent that they felt that this was a fundamental right The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 16 that they would not wish to give up. In addition to this five residents said that they had financial advisors or legal representatives who helped them administer their finances. The manager explained that all members of staff received protection of vulnerable adults training as part of their initial induction. This was confirmed through a spot check of training records. There were policies about this available for staff in the office. A recent incident occurred regarding one resident’s finances which could have been construed as financial abuse. This was dealt with promptly and professionally by the manager who used the protection of vulnerable adults policy appropriately. This incident resulted in disciplinary action- indicating that the home is not afraid to challenge bad work practice. Lengthy discussion took place about the organisation’s policy of retaining residents’ free nursing contribution as part of the weekly fee. The manager was asked to ensure that this was included in the initial information sent out to prospective new residents and in the service user guide. This was acted upon promptly at the time of this visit. It is important that residents have this knowledge so that they can make more of an informed choice about their future care needs. It also enables the home to provide a more transparent service. The manager explained that the nursing contribution is taken directly from source but that residents could request to have this money sent to them. They could then be invoiced by the finance department. This option was included in the initial enquiry letter. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 17 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 standard(s) 19,20.21, 22, 23, 24, 25 & 26 The Garden House is well maintained, clean, comfortably furnished and has many up to date adaptations. Residents can therefore be assured that they will benefit from a homely environment which has the resources to maximise their independence. EVIDENCE: The Garden House is situated on a large estate near the downs and a number of residents commented about the pleasure they get from being in such an environment. The grounds are well maintained and there is a pond and accessible pathways for people who use wheelchairs. Some residents’ bedrooms lead out on to their own gardens which they maintain themselves. This is good practice. One resident also explained that there was a garden with raised flower beds which suited her because of her disability. The Garden House has been open for two years and is purpose built. As such it is fully accessible and has a number of aids and adaptations throughout the premises to enable physically disabled residents to maximise their The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 18 independence. This includes wide corridors and doorways, overhead tracking for hoists, lowered light switches, specialised bathing facilities, grab rails and assisted toilet facilities. A number of bedrooms were seen at the time of this visit. They were personalised and reflected individual tastes – indicating that choice and independence are promoted in this respect. A number of residents commented that they were able to bring in items of furniture which made it feel more like home. The majority expressed satisfaction at the facilities available although some said there were teething problems with the premises at the beginning which now appear to have been resolved. One resident said that they were having problems with noise from a kitchen opposite their bedroom but that staff now kept the door closed which had reduced the noise significantly. She said that they occasionally forget to shut the door but that she reminds them. It was noted that the home has a glass panel overlooking the staircase, which could cause some disorientation to those who are visually impaired. It was recommended that the manager seek residents’ opinions about this during their monthly meeting and take action if necessary. The home has a comprehensive maintenance programme and it was noted that defects are reported promptly and made good. The manager confirmed there have been difficulties with four ensuite showers which tend to flood due to the incline in the floor. She produced a letter from the manufacturers who have undertaken to make this good when residents vacate the rooms. She said that this does not affect residents but means that staff have to wear protection on their shoes. At the time of this unannounced visit the home was found to be cleaned to a high standard and there were no unpleasant smells. The housekeeping staff have worked hard to maintain good standards in this respect. Residents explained that they send their clothes to the laundry on a weekly basis. They said they were satisfied with arrangements in this respect. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 19 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 &30 There are robust and comprehensive procedures in place for the recruitment, supervision and training of staff which are in place for the protection of vulnerable adults. Residents can be confident that they will receive a specialist service from a competent and qualified staff team. EVIDENCE: Staffing rotas indicated that there are eleven nursing care assistants on duty throughout the day and these are distributed between to distinct areas of the premises. In addition to this there are housekeeping staff, porters and kitchen staff. There are two qualified nurses on duty at all times. These staffing levels are commendable and sufficient to meet with the needs of those residents currently accommodated. Opportunity was taken to view two staff personal files. These included completed application forms, returned references and police checks. The manager confirmed that they also undertake a protection of vulnerable adults check prior to recruitment. It was evident that there is a robust recruitment procedure in place that is designed to protect vulnerable adults. Currently over 70 of the staff team have a national vocational qualification, level two or above. Discussion with staff and training records indicated that St Monica’s Trust is committed to providing this training for all the staff team. This is good practice. There are a number of assessors employed within the organisation to enable the home to keep up to date with the demands of providing such extensive training. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 20 In addition to the above the Garden House has a comprehensive induction procedure. New employees are issued with portfolios and a training schedule so that they can begin to gather the underpinning knowledge and evidence towards their NVQ. This was further evidenced through records and discussion with staff. In addition to the above it was noted that there are external courses booked throughout the year which concentrate on specialist areas. Forthcoming sessions include in relation to Parkinson’s, disability awareness and death and bereavement. Information in relation to this was also available in the office.. It was evident from the above that the organisation provide extensive opportunities for staff to train and that this means the home employ well trained staff who are competent to do their jobs. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 21 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,36,37 & 38 Records are maintained to a good standard and residents can be assured that there are effective procedures in place to maintain a safe environment. EVIDENCE: It was apparent through discussion with the residents and staff that the manager is held in high regard. Records provided evidence that the home has a well established formal supervision system through which all staff can discuss their developmental needs and air any concerns. This is good practice. Opportunity was taken to view the fire logbook – this provided evidence that the home makes the appropriate checks of the system at regular intervals. In addition to this there are periodic fire drills and all staff receive re-fresher fire training. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 22 Training records indicted that there are good systems in place to ensure that all staff receive their statutory health and safety training, including first aid, manual handling and infection control. St Monica’s Trust have a number of health and safety policies which were available but not looked at in depth during this inspection. Staff induction records indicated that key policies are discussed with new employees as part of their initial training. They are also encouraged to sign their awareness of these. This is good practice. The kitchen was found to be cleaned to a good standard and staff maintain up to date records of fridge and freezer temperatures. In addition to this they regularly probe food to ensure that it reaches safe temperatures. The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 23 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x x 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 4 COMPLAINTS AND PROTECTION 4 4 4 4 4 4 3 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x x x x 3 3 3 The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 24 no 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. 3. Standard 9 9 9 Regulation 13(2) 13(2) 13(2) Requirement Maintain accurate records of all medication administered and held on the premises Ensure all medication is given only to people who it is prescribed for Review the competency of all staff who give out medication Timescale for action 9 May 2005 9 May 2005 9 June 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 7 9 15 Good Practice Recommendations Continue to develop care plans Develop individual medication profiles Consult with residents about the availability of a hot snack at supper time The Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 Page 25 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 Garden House D56_46263_TheGardenHouse_223859_090505_Stage2.doc Version 1.30 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. 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