Inspection on 24/05/05 for The Gloucester

This inspection was carried out on 24th May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Gloucester 24/07/07

The Gloucester 12/10/06

The Gloucester 03/05/06

The Gloucester 15/02/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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 Gloucester 83 Gloucester Road North Filton South Glos BS34 7PT Lead Inspector Jackie Hargreaves Announced 24 May 2005 09:30 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 Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service The Gloucester Address 83 Gloucester Road North Filton South Glos BS34 7PT 0117 9699626 Alutarius@aol.com Alutarius Ltd 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) Mr Neil Andrew Plummer Care Home for Older People 13 Category(ies) of OP Old age 13 registration, with number of places The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Not Applicable Date of last inspection 15-Feb-2005 Unannounced Brief Description of the Service: The Gloucester is registered with the CSCI to provide care and accommodation for up to 13 older people. In October 2004 there was a change of service provider. The home is now operated by Alutarius Limited and managed by Mr Neil Plummer. The property is situated on the A38 Gloucester Road approximately 4 miles North of the centre of Bristol. The home is on major bus routes and the M32 and M4 are easily accessible from the home. Local amenities are within walking distance of the home. Accommodation is provided on three floors. There is a passenger lift. There are nine single and two double bedrooms. The home has two lounges, a dining room and a kitchen on the ground floor. There are bathroom and toilet facilities on each floor. There is level access to a patio area to the rear of the premises and steps to a small garden area. There is access to the garden from the side of the property. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection of the home since registration of new service providers and home manager in October 04. This announced inspection focussed primarily upon the requirements identified at the previous inspection to assess compliance with the Care Homes Regulations within the given timescales. The inspection found that good progress had been made to address requirements made at the previous inspection and with care planning. However, the requirements made in this report demonstrate that there are areas where further progress is required to ensure the welfare and safety of residents is fully promoted. What the service does well: What has improved since the last inspection? There was evidence of improved relationships with relatives. There have been improvements to the writing of care plans, which need to be further developed to ensure the holistic needs of residents are being met. The home has enabled residents to air their views on the care and services they receive. Residents stated that they were asked about their likes and dislikes and were able to make choices about the service they received. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 6 The home has taken steps to improve the range of activities provided outside the home. What they could do better: Overall the home needs to improve upon staff training to meet the needs of residents and ensure their safety. Urgent action must be taken to ensure that 50 of staff are qualified to NVQ level 2 in care. Further consideration must be given to how the home demonstrates promotion of safe working practices and maintenance of a safe environment. The report has required that the service ensures care/actions plans accurately reflect all residents personal, healthcare and social needs and how they are to be met in ways that residents prefer. Evidence of staff training on First Aid the administration and control of medicines must be held in the home and available for inspection. The registered person should continue to ensure that radiator covers are fitted to all radiators where there is a risk to residents personal safety. Residents chosen activities should be recorded and show residents choices, considerations for physical, mobility and health needs, and the resources provided to enable their full participation. The stairway accessing the third floor should be assessed for a handrail to ensure the safety of residents. The manager should ensure that the home’s induction training matches national Skills for Care standards to ensure residents benefit from good, safe working practices. Residents rooms should be audited against the list of fittings and furnishings required of National Minimum Standard 24 to ensure that they meet the standard. The quality of cooked food served in the home should be improved. The service must ensure that requirements made at inspections are addressed within the specified timescales. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 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 standard(s) 1,2,3,4 Residents were supplied with information about the home and were properly assessed before entering the home. However staff need to be trained to National Standards to ensure that the needs of residents entering the home can be fully met. EVIDENCE: Progress had been made to update information on the home’s services and facilities in line with National Minimum Standards. There was a guide to the home displayed in the entrance area. The inspector was shown a new draft contract between the home and residents that was to be discussed and agreed with each person and/or their representative prior to being signed by all parties. Records kept on two most recent admissions included assessments of the resident’s personal, healthcare and social needs. Discussion with staff on duty indicated that most of the residents care needs were being addressed although most staff were not yet fully involved in care The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 10 planning with residents to meet all of their care and daily living needs and several staff were not trained to National Standards. However, it was positively noted that five staff had worked in the home for five years or more, some distance learning was taking place, and senior staff were undertaking pre NVQ training. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 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 standard(s) 7,8,9,10 Progress had been made to identify and record residents’ care needs in care plans, however, further expansion of the plans is required to demonstrate that all personal, healthcare and social needs are met in ways that resident’s prefer and their dignity is promoted at all times. EVIDENCE: Individual plans of care were available. The inspector examined four plans. The plans were developing well to meet the personal care needs of residents. Care needs were clearly written and important health care needs were referred to in the plans. Essential things that staff needed to be aware of while providing care had been noted in the plans and important needs/issues summarised. Not all plans had been expanded to cover all aspects of health, social and personal care needs listed in the homes Admissions Criteria. Risk profiles that identified instances where there may be a risk to a resident’s personal safety were in place. Discussions with residents and a visiting relative indicated that staff and the home manager addressed resident’s health needs and emotional and practical The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 12 support was given. Details of GP visits and health checks/services provided to residents were recorded in a separate book. Colostomy care for a resident was well recorded and supported by the GP and District Nursing Service. One resident with significantly reduced mobility and who used a wheelchair had been supplied with a pressure-relieving mattress and medical sheepskin some time ago. A staff member spoken with had some knowledge of bedsore prevention. However, it would be good practice to involve the district nurse to ensure staff are fully knowledgeable about prevention of pressure sores. The inspector observed that a health concern reported by a resident to a staff member was responded to immediately and the GP called. Following a requirement at the previous inspection medicines were held securely. As the home was recently registered with new providers and management the CSCI pharmacist has been asked to review the medication policies and practices at the home. Records of staff training in medicines was not available although the manager advised this training had been undertaken. Accredited training on the administration and control of medicines was currently not available and it is recommended that this is accessed. Residents told the inspector that they could choose when to go to bed. However, the inspector was concerned to see two residents dressed in their night attire in the lounge before 7.30pm. Whilst it is essential that residents have a choice of daily routine, full dignity for all residents at all times should be promoted as a matter of good practice. Accident forms had been completed by the manager, however, the inspector noted that the CSCI had not been notified, in accordance with Regulation 37, of a fall resulting in a resident being taken to casualty. The manager took copies of a form for this purpose. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 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 was progress in the range of activities provided however, improvements to the quality of cooked meals should be addressed. EVIDENCE: Residents and a visiting relative were appreciative of the wider variety of activities provided outside the home. These were organised by a deputy manager and included trips out for lunch and to places of interest with transport provided. One resident said that staff had taken her to Church on Sundays and to the shop and residents said they enjoyed the daily games and quizzes. To demonstrate that all residents choose and have the opportunity to participate in stimulating and chosen activities these should be recorded showing considerations for physical, mobility and health needs and the resources provided to enable their full participation. Relatives and friends were welcome in the home. A visiting relative said that members of staff were friendly and helpful and the manager had been supportive. Residents who commented on the food provided said that breakfasts were ‘alright’ and fruit and snacks were available. However, comments about the The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 14 standard of cooked dinners were generally unfavourable and included, ‘not good’, and, ‘sometimes overcooked’. This was brought to the attention of the proprietor and manager for improvement. The inspector saw that matters relating to food and kitchen hygiene identified in the environmental health officer’s visit to the home were being addressed. A follow up visit was due. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 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) 16,18 Residents were confident that complaints would be acted upon, however, the service needs to demonstrate that training for staff is provided and in line with local policies on the protection of vulnerable adults to ensure appropriate responses to suspected or alleged abuse. . EVIDENCE: A complaints leaflet was displayed in the home’s entrance area and complaints procedures were referred to in the guide to the home, also on display. A visiting relative was fully aware of the complaints procedures and said that she would, ‘go straight to the manager’, if she had concerns and would be confident they would be dealt with. One complaint made in the home relating to the attitude of a staff member had been resolved. One resident who commented upon ways of expressing concerns said that residents could air their views and, ‘things mentioned would be done’. There were policies and procedures in place on whistle blowing and the protection of vulnerable adults. The manager was aware of the need to ensure these had a high profile in the home and advised the inspector of plans for them to be included in a staff handbook and discussed in staff supervision and staff meetings. Confirmation of staff training on the protection of residents from abuse was not available. The inspector advised that training should correspond with local policies and procedures and provided details for obtaining training advice locally. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 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 standard(s) 19,21,25, Requirements have been made to ensure that residents have access to safe surroundings. EVIDENCE: As noted at the previous inspection, there was a commitment by the new proprietors to ensure the home was well maintained and this was evidenced by confirmation of recent checks on maintenance and associated records supplied to the CSCI in a pre-inspection questionnaire completed by the proprietor. A part-time handyman had been employed and a new staff member told the inspector that she had been employed to help with cleaning and cooking. The home was clean and tidy of the day of the inspection. There had been no changes to the premises since the previous inspection undertaken in February 2005. Issues relating the environment identified at this inspection were as follows: The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 17 • Resident’s rooms viewed did not have radiator covers. The proprietor advised the inspector that rooms had been risk assessed and covers ordered where a risk was identified. Room 8 did not have a lockable cupboard to enable the resident to keep valuables safe if so wished. The radiator in the top bathroom was very hot. The inspector was advised that residents did not use this bathroom. The stairway accessing the third floor did not have a handrail and this should be addressed to ensure the safety of residents. The middle floor bathroom was well used. There was an old style sluice sink situated next to the bath. The proprietor advised the inspector that the sink was not used, however, a staff member stated that it had been used for emptying commodes. This was brought to the attention of the manager for appropriate action to be taken. The home had one bath hoist to assist residents with mobility needs. On examination the underside of the hoist was found to have rusted which places residents at risk of infection and must be repaired or replaced. • • • • • The proprietor was considering plans to reduce the number of bathrooms to two. Written proposals should be submitted to the CSCI for consideration. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 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 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 Procedures for the recruitment of staff provided safeguards and promoted protection of residents living in the home however staff must receive sufficient training to meet the ongoing needs and safety of residents. EVIDENCE: There was a stable staff team. Only one part time care staff member had left the home since registration with the CSCI of the new proprietors and manager in October 04. All staff employment records were examined which demonstrated the home had undertaken satisfactory recruitment checks to ensure the protection of residents, there being only one shortfall of copy identification and references for the most recently recruited staff member, which still had to be transferred to the home from Head Office. The inspector examined Criminal Record Bureau Checks carried out for all staff and found these to be satisfactory. Staff had been supplied with contracts of employment. Examination of the home’s duty rota for two weeks in May 05 showed a minimum of two care staff on duty during the waking day to carry out caring duties plus the manager. The manager had covered care hour duties two days each week. There was one waking night staff and one sleeping in staff. Residents spoken with said that staff were friendly and helpful and residents were able to, ‘have a chat and laugh’ with staff although two resident commented that, ‘sometimes staff were pushed for time’. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 19 Staff training in manual handling had been provided since the previous inspection. There was a staff induction checklist that was used when providing new staff with basic induction training. The manager should ensure that the home’s induction training matches National Skills for Care standards to ensure residents benefit from good, safe working practices. Foundation training that meets Skills for Care Standard was not available and should also be pursued. There were no staff working in the home qualified to level NVQ level 2 in care although pre NVQ training was ongoing for senior staff. NVQ training for all staff should be addressed as a priority to ensure that staff have the knowledge and skills to meet the care needs of residents and the service complies with National Minimum Standards. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 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 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) 31.32.38 There needs to be planning to ensure effective management and full promotion the welfare and safety of residents. EVIDENCE: Residents and a visiting relative said there was a good atmosphere in the home and meetings were held with staff where residents could air their views. The home’s registered manager had made progress towards addressing requirements made at the previous inspection. Some remain outstanding or have been partially addressed and must be complied with within the extended timescale granted at this inspection. To assist the manager to fulfil his management responsibilities a second staff member had been appointed deputy manager although roles and responsibilities for this senior position had not been clarified to support effective management of the home. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 21 A company financial business plan was supplied to the CSCI at the time the service was registered. A development plan specific to The Gloucester would provide a clear direction for the home and would enable management to identify priorities for developing the service for residents, quality assurance and to meet National Minimum Standards. Following a requirement made at the previous inspection policies and guidance on health and safety matters and safe working practices were produced and held in a Health and Safety manual accessible to staff. Infection control guidance had also been obtained. One staff member held an up to date First Aid Certificate. Evidence of further staff training in First Aid was not available at the time of the inspection. The proprietor advised the inspector that all senior staff had received this training in 2004. Evidence of this training must be held in the home for inspection purposes to demonstrate there is a staff member on duty at all times who knows how to deal with accidents and health emergencies. Three fire doors were wedged open. This practice does not comply with fire safety regulations and the manager was advised that these doors should be kept closed at all times. Should a resident wish to keep a fire door open a selfclosure release that complies with fire safety should be fitted. Records indicated that fire drills and staff instruction on fire safety in the home had taken place. As the last fire officer’s visit to the home was unknown the CSCI has requested a local fire officer makes a visit to the home. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 2 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 1 COMPLAINTS AND PROTECTION 2 x 2 x x x 1 x STAFFING Standard No Score 27 2 28 1 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 1 3 2 x 2 x x x 1 The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 23 YES 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. Standard 1 Regulation 4 Requirement Timescale for action 30.07.05 2. 7 5 The registered person must ensure that the CSCI is supplied with a copy of the updated Statement of Purpose to demonstrate that it has been updated to meet the Care Homes Regulations 2001. The registered person must 30.07.05 ensure that care/actions plans accurately reflect all residents personal, healthcare and social needs and how they are to be met in ways that residents prefer. New draft contracts between the home and residents must be discussed and agreed with each resident and/or their representative and signed by all parties. 01.09.05 3. 4. 2 5 5. 6. 8 37 The CSCI must be informed of all 24.05.05 events which adverseley affects the well being of safety of any resident. Evidence of staff training on the 01.09.05 administration and control of medicines must be held in the home and available for inspection. D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 24 7. 9 13 The Gloucester 8. 9. 18 13(6) Evidence of staff training on the protection of vulnerable adults must be held in the home and available for inspection. The registered person is required to ensure that radiator covers are fitted to radiators where there is a risk to residents personal safety. The manager should ensure that the sluice sink situated next to a bath is not used for emptying commodes. The bath hoist must be repaired or replaced to eliminate the risk of infection. The registered person must ensure that 50 of staff working in the home achieve NVQ level 2 in care by the end of 2005. The registered person must ensure that there is a fully trained person in first aid in the home home at all times and ensure that evidence of staff training in First Aid is held in the home and available for inspection. Fire doors must not be wedged open. 30.09.05 10. 25 13(4) 30.09.05 11. 21 13(4) 24.05.05 12. 13. 21 28 13(4) 18(1)(c) 01.08.05 01.09.05 14. 15. 38 13(4) 01.08.05 16. 38 23(3)(4) 24.05.05 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. Refer to Standard 8 12 Good Practice Recommendations The service should involve the district nurse to ensure staff are fully knowledgeable about prevention of pressure sores. Residents chosen activities should be recorded and show considerations for physical, mobility and health needs and D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 25 The Gloucester 3. 4. 5. 6. 15 24 19 30 7. 8. 9. 10. 11. 34 24 10 9 4 the resources provided to enable their full participation. Improvements should be made to the quality of cooked meals. A lockable facility should be provided in all residents rooms to enable the resident to keep valuables safe if so wished. The stairway accessing the third floor should be assessed for a handrail to ensure the safety of residents. The manager should ensure that the home’s induction training matches national Skills for Care standards to ensure residents benefit from good, safe working practices. A development plan should be put in place to provide a clear direction for the home. Residents rooms should be audited against the list of fittings and furnishings required of National Minimum Standards 24 to ensure that the meet the standard. The home should ensure that full dignity for all residents at all times is promoted as a matter of good practice. The home should seek accredited staff training on the administration and control of medicines. A training programme should be developed to provide staff with training appropriate to residents needs. The Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 26 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 Gloucester D56 D05 S61774 The Gloucester V220955 240505 Stage 4.doc Version 1.20 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!