Inspection on 21/08/06 for The Gatehouse

This inspection was carried out on 21st August 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 Gatehouse 13/01/10

The Gatehouse 26/09/07

The Gatehouse 08/05/07

The Gatehouse 08/02/07

The Gatehouse 19/01/06

The Gatehouse 22/07/05

The Gatehouse 18/01/05

The Gatehouse 24/08/04

The Gatehouse 18/09/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Gatehouse 64 Becton Lane Barton-on-sea New Milton Hampshire BH25 7AG Lead Inspector Beverley Rand Unannounced Inspection 21st August 2006 10:00 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 Gatehouse DS0000012359.V303629.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 Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Gatehouse Address 64 Becton Lane Barton-on-sea New Milton Hampshire BH25 7AG 01425 613465 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) Mr E Breckon Mrs J Breckon Mrs Sally Price Care Home 21 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (21) of places The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: The Gatehouse is set in a semi-rural location on the outskirts of the town of New Milton at Barton-on-Sea with access to local amenities. It provides residential care for up to 21 elderly residents, some of whom have dementia. The home is on ground and first floors and there is a stair lift between these. There are a variety of aids and adaptations to allow residents to move about more independently. Nineteen of the bedrooms are single, and one is a double. All of the bedrooms bar one single have an en-suite facility. There is a communal bathroom with toilet on the ground floor, and two bathrooms with toilets on the first floor. There are large gardens around the building, and car parking space to the front. Current fees are between £425 and £475 a week. The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and the inspector looked around the home and garden, spoke with seven residents and two staff. The registered manager is currently on maternity leave and the inspector was assisted by the deputy manager who is managing the home. The inspector also looked at records such as medication records, staff recruitment and training files. What the service does well: What has improved since the last inspection? The last report did not suggest any improvements to the home. The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 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 Gatehouse DS0000012359.V303629.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 Gatehouse DS0000012359.V303629.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): 3. Standard 6 does not apply to The Gatehouse. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home ensures that prospective residents have their needs assessed before they move into the home but assessments could contain more information to ensure their needs can be met. EVIDENCE: The deputy manager said that prospective new residents are invited to spend a day in the home, whereby a risk assessment is completed. If people could not visit the home they would be visited where they were. Residents move in on a month’s trial. The inspector looked four assessments, which were based on a tick box format. Whilst assessments showed individual detail such as what name the resident preferred to be called, a more recent assessment did not relate to the subsequent needs identified since the resident had moved in. The format used for this assessment did not include mental health information and the home has not reassessed needs or sought further professional advice. The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 9 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 poor. This judgement has been made using available evidence including a visit to the service. There is a care plan in place for all residents but some are not detailed enough and do not meet individual needs. Some residents are not protected by the home’s medication administration procedures. The home ensures healthcare professionals are contacted if residents are unwell and residents feel their privacy and dignity are respected. EVIDENCE: Residents have an individual care plan which identifies areas of need. Care plans give limited information, but many of the residents are independent and care plans reflect this appropriately. However, the inspector case tracked a particular resident whose care plan did not reflect the ongoing mental health needs and associated behaviour identified in the daily records. The care plan must identify strategies for responding to these needs. Additionally, there was not a photograph on file which could have been necessary following recent events. The care plan was reviewed monthly but was not changed when certain behaviours became apparent. One resident identified that different staff attended to personal care in different ways, which they were dissatisfied with, and the inspector found the care plan did not detail what level of support was needed. This means that staff do not have a routine to follow and therefore The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 10 work in different ways. The deputy manager was able to show that the care plan had been reviewed on a monthly basis, but residents were not involved in the review. The deputy manager told the inspector that one resident did not eat a particular type of meat and that this was due to her religion, but did not know of any further cultural or religious needs in this respect. The care plan or assessment did not identify that the resident did not eat this meat, nor did it identify her religion. On further discussion between staff, views were divided as to whether it was religion or that the resident did not like this meat. The home has links with healthcare professionals such as doctors, district nurses, chiropodists and dentists. There was evidence to show that doctors were called when residents became unwell. Whilst reading daily records, it was noted that one resident had been given their tablets but had disposed of them. In further discussion, it was found that the tablets were probably not replaced as they were not sure which ones the resident had taken, and that it was ok for them to be missed. However, it was not known what the tablets were for. The home did not have a Patient Information Leaflet and the deputy manager said the medication was not listed in her reference book. No one had telephoned the doctor to see what the tablets were for and whether missing them would have a detrimental effect and therefore the resident’s health may have been put at risk. The inspector looked at five medication records for the last two weeks and four were seen to be completed appropriately. However, one record was regarding the resident detailed above. Another resident’s records showed gaps for a particular medication over five days in August. The deputy manager was asked why there were gaps and she said the resident would have refused. She proceeded to write R in these gaps. The inspector suggested that she could not know that the resident had refused on these dates. The inspector looked at the daily records and found that on all dates except one the medication had been taken to the resident in their room. On the other day there was no mention as to whether the resident had been given it or not. Insulin and eye drops were stored in unlocked containers in a fridge in the kitchen area. During the inspection, the weekly medication was delivered and left in the office. Although the cook was based in the kitchen, which is next to the office, the external office door was open and the medication was not secure, contrary to the Royal Pharmaceutical Society guidelines. The home does not have an appropriate receipt and administration procedure in place. Staff told the inspector how they administered medication and were observed whilst undertaking the lunchtime medication round. Staff sign the records as they dispense into named pots, thereby making it difficult to change records if medication is refused or otherwise not taken. Records should be signed after the medication is taken. One staff member signs the records, dispenses tablets into a pot which is then put into another pot or onto trays. That staff member, plus others who are available then take the medication to the residents. The The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 11 person who signs the records should administer the medication. Additionally, staff were observed to pop tablets from the blister packs or in one instance, a bottle, into their hand before putting it into the pot. One tablet was held onto for some time before being put into the pot. Staff have not had formal training in medication administration since 2002, and new staff have not had any external training. A training session has been booked for October and all staff have been asked to attend. Staff gave examples as to how they respected residents’ dignity when undertaking personal care and residents confirmed that they had help in areas they could not manage. One resident said they had never felt embarrassed when having a bath. Residents also said that most care staff knocked on their bedroom doors before entering. Care plans showed what name residents preferred to be known as. The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that residents can make individual choices, can participate in activities and furnish their rooms as they wish. The home provides a varied diet which residents enjoy, although supper menus should be reviewed. EVIDENCE: Activities include bingo, exercises to music, quizzes, games such as Scrabble, singers and trips out for those who feel able. Children from the local school visit the home in term time and sing for the residents. Five residents who spoke with the inspector about activities felt that there could be more, but also identified that when activities were organised they were not well attended. Some residents are independent in their individual activities. Residents said they could please themselves when they went to bed, and some had breakfast in bed before getting washed and dressed. The home has a visitors policy which states that visitors are welcome but requests that they avoid lunchtime if possible. Residents are able to bring their own furniture and ornaments into the home and the inspector saw evidence of this during a tour of the home. The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 13 The home displays a weekly menu on the dining tables, so that residents can see what the meals will be for the week. The menu was varied and all residents spoken to said they could have something other than what was on the menu. Residents’ views regarding the food were mixed. Most who spoke with the inspector felt that lunch was good, but some felt that, ‘supper sometimes left something to be desired’. On further discussion it seemed that some residents felt that the quality of cooked food varied depending on which care staff had cooked it. One resident said they would choose a sandwich rather than the cooked supper, for this reason. Another resident said the supper was ‘ok’ but that they sometimes did not like the lunch menu. The home employs two cooks, and on the day of the inspection the cook was seen to have made cakes. The home knows individual likes and dislikes and keeps a record of food provided. The home currently caters for four residents with diabetes, and the cook provides puddings made with sweetener. The home provides a chilled bottled water machine so that residents can help themselves to water when they wish. One resident was seen to enjoy collecting the cups after morning coffee. The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 14 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 adequate. This judgement has been made using available evidence including a visit to the service. Residents feel able to make their views known and generally feel action would be taken. The home’s procedures may not protect residents from abuse. EVIDENCE: All residents who spoke with the inspector said they would feel able to discuss any issues of concern with the manager or provider, as they were both approachable. All but one resident felt that action would be taken to rectify any complaints. The complaints procedure is included in the Service User Guide which is given to all residents. The inspector spoke to staff and the deputy manager regarding the procedures they should follow if there was an allegation or suspicion of abuse. The staff member was aware of the Whistle Blowing procedure and felt that the manager would talk to all involved parties to undertake an investigation. The deputy manager said she would speak to the different parties involved and if the stories did not tally, she would, ‘monitor very closely’. On further discussion she also thought she could contact the police and inform the Commission, but was not aware of the role of the local authority adult services department. The home’s procedure was unclear about the role of the local authority adult services in leading any investigation. One staff member who was asked said they had not had any training in Adult Protection, and the deputy manager said she had had some training as part of a National Vocational Training course, level 3. The deputy manager said staff have not had any training in the protection of vulnerable adults. The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 15 The Gatehouse DS0000012359.V303629.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 good. This judgement has been made using available evidence including a visit to the service. The home provides a pleasant and clean environment but may benefit by having clear procedures in place regarding laundry facilities. EVIDENCE: The inspector looked around the home and saw that the majority of bedrooms are single, on the ground floor and with views over the garden. All of the bedrooms except one have an en-suite facility: some have basins and toilets, some have a bath as well. The home has provided four bath seats for en-suite baths where residents have a need in this area. Some residents have their own summer bedding plants outside of their bedroom patio doors. Residents said it was a ‘lovely environment, you couldn’t want better’, ‘it’s a nice place to be, I count my blessings’, ‘having our own bathroom is very nice’. The home was clean and one resident expressed the view that staff over cleaned the home, and felt the time could be better spent encouraging residents to get involved in activities. The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 17 The most direct route to the laundry is to go through the kitchen and the deputy manager said staff should go around the house to avoid walking through the kitchen. However, the home does not have a written procedure regarding laundry and one staff member said they did take dirty laundry through the kitchen. The laundry does not have a sink or a hand wash facility which means that the risk of cross infection from contaminated laundry may be higher. Staff described the procedures they followed regarding wet bedding and this included washing it on its own, but were less clear what to do with soiled bedding. The deputy manager said soiled bedding could be rinsed in a bucket in the staff toilet. The laundry walls are painted bricks and the paint had peeled in a few places. The floor was bare concrete and chunks had been gouged out, meaning that the floor was not impermeable or easily cleanable. This also may pose a risk regarding cross infection. The Gatehouse DS0000012359.V303629.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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. Whilst residents’ needs are met by the number of staff employed, they would benefit from more staff being qualified to NVQ standard and a training plan for moving and handling being in place. The home’s recruitment process does not protect residents. EVIDENCE: The staffing rota is recorded in the diary but is written in pencil and any changes are rubbed out. The inspector advised the deputy manager that as a record of the rota and any changes made had to be kept for three years they should be written using indelible ink. The rota showed there to be three care staff plus the deputy manager on duty in the mornings, and three in the afternoons. The home also employs two cooks who cover the week between them and one domestic. Residents said some staff were, ‘excellent’ and that they did, ‘try to meet your needs’. Staff were, ‘all very kind’ and tried to make it nice for residents. One resident said, ‘staff are very busy but they will give you time’. The home employs twenty care staff, some of whom work one night a week. Four night staff have achieved the National Vocational Qualification, (NVQ) in Care, Level 2 and one has also completed NVQ3 but none of the eight day staff have yet achieved the award. One staff member is a registered nurse and two staff are enrolled on the NVQ2 course. The standard suggests that 50 of care staff should be qualified to at least NVQ2 and these figures show that this standard is not met. The deputy manager said that staff who had not undertaken the course did not want to. The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 19 The deputy manager advised the inspector that a new staff member was due to start work in the afternoon of the 21st August. Recruitment checks had not been undertaken: there were no references, Criminal Records Bureau, (CRB) check or Protection of Vulnerable Adults check, (POVA). The deputy manager said she had seen a recent CRB check from the previous employer and that the staff member was coming to ‘shadow’ and believed this to be acceptable. She was advised that this was not acceptable and subsequently asked the staff member not to come in. The recruitment records were looked at for another new staff member who started work on 19/6/06. Two references were on file but one was sent out on the 17th July which was after the person started work, and the other reference was dated 1999 and addressed to ‘whom it may concern’, which could not be considered to be acceptable. The CRB check had not been completed and although the deputy manager said she remembered receiving a telephone call regarding the POVAFirst check, this was not recorded anywhere and therefore it could not be evidenced as to whether this check was in place before the person started work. The home did not have a written recruitment policy in place. Staff had undertaken training courses such as First Aid, Fire Safety, Food Hygiene, Moving and Handling and Care Giving in Dementia. However, there was not a date set for refresher training for Moving and Handling and this should be reviewed. Records showed that thirteen staff out of twenty had undertaken fire safety training in July this year, but there was not a system in place to ensure staff attend twice a year or a date set for those who had not attended. The home uses an induction and foundation training pack, and the inspector saw one which was ticked as being completed but not signed or dated by the deputy manager or the staff member. Induction records should be signed to evidence that the work has been undertaken and the timescale used. The Gatehouse DS0000012359.V303629.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): 33, 35, 37 & 38. 31 could not be assessed. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents’ opinions of the home are sought. The home does not have a suitable system in place for ensuring residents’ financial interests are safeguarded. The home ensures that equipment is maintained but a review of the storage of hazardous cleaning fluids would ensure health and safety of service users are fully protected. EVIDENCE: The registered manager is currently on maternity leave and the home is being run by the deputy manager. The deputy manager did not know when the manager had last sent out a quality assurance questionnaire, but was planning to send one out again to residents. One of the residents said she had received a questionnaire but did The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 21 not say when. The last questionnaires which could be found were completed in March 2005. The home looks after money on behalf of some residents and the inspector looked at financial records and monies for three residents. Records for one tallied with the amount of money held in the safe, but one did not, and one was not accurately recorded. The deputy manager said she had counted the amount of money in one envelope and had recorded that figure, rather than calculating what should have been there. The other record showed that a certain amount of money was given to the home to look after, but because some money was already owed to the home, the records only showed the net balance as being deposited. All money in and out must be recorded accurately and a more reliable system must be used. Records within the home were securely kept in the office. However, archived medication records and care plans for residents who had died were stored in a garden shed which was not locked. Records held in a care home must be securely kept to maintain confidentiality. Fire records showed that fire alarms were tested more or less weekly and emergency lighting monthly. There was a record of maintenance for fire equipment from an external company. Maintenance certificates were available for bath seats and the stair lift. The inspector tested the temperature of the bath water and found this to be acceptable. Hazardous substances including bleach were stored in areas where residents could access them, and trays of cleaning materials had been left in the hallway and a bedroom while staff had their break. The home is registered for people with dementia, and whilst only one was known to ‘wander’ around the home the provider must review this practice. The home does not have a policy or risk assessment regarding the storage of hazardous substances and these must be put in place. The Gatehouse DS0000012359.V303629.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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 2 X 2 2 The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 OP7 OP9 Regulation 15 (b) 13 (2) Requirement Care plans must detail how the residents’ mental health needs are to be met. The home must have a written procedure regarding the receipt and administration of medication. All medication must be securely stored. All medication records must be fully completed. Professional advice must be sought when residents dispose of their medication to determine whether there will be any detrimental effect on their health. All staff must attend training in the protection of vulnerable adults. The adult protection procedure must be made clearer with regard to the role of the local authority adult services. The registered person must ensure that all checks are in place for all new staff, including those recently recruited. These checks must be in place before new staff begin work. DS0000012359.V303629.R01.S.doc Timescale for action 30/10/06 30/09/06 3 4 5 OP9 OP9 OP9 13 (2) 13 (2) 13 (2) 30/09/06 30/09/06 23/09/06 6 OP18 13 (6) 21/11/06 7 OP29 19 (1) 30/09/06 The Gatehouse Version 5.2 Page 24 8 OP35 17 (2) Schedule 4 17 (2) Schedule 3 13 (4) 9 10 OP37 OP38 An accurate record must be kept of all money received into the home on behalf of residents and any money paid out from their accounts. The home must have a photograph of every resident. The registered provider must review the practice of leaving hazardous substances where confused residents can access them and undertake a risk assessment. A written procedure for the storage of such substances must be in place. 21/09/06 21/09/06 21/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP15 OP26 Good Practice Recommendations The home should review supper menus. The home should have clear procedures in place for avoiding taking soiled laundry through the kitchen. The provider should also consider whether the home would benefit from a hand wash sink and sluicing facilities. A minimum of 50 of care staff should be trained to NVQ2. The home should ensure there is a moving and handling refresher training programme in place. 3 4 OP28 OP30 The Gatehouse DS0000012359.V303629.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Gatehouse DS0000012359.V303629.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. 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