Inspection on 19/12/05 for The Grange

This inspection was carried out on 19th December 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 Grange 10/09/07

The Grange 23/10/06

The Grange 14/06/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Grange (The) 69 Southend Road Wickford Essex SS11 8DX Lead Inspector Ms Vicky Dutton & Ann Davey Unannounced Inspection 19th December 2005 08.15 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 Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 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. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grange (The) Address 69 Southend Road Wickford Essex SS11 8DX 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) 01268 766466 01268 767130 Runwood Homes Plc Manager post vacant Care Home 43 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (43) of places Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Personal care to be provided to up to 43 older people. Personal care to be provided to up to 22 older people with dementia. Maximum number to be cared for shall not exceed 43. Date of last inspection 14th June 2005 Brief Description of the Service: The Grange is registered to provide care and accommodation for forty-three older people, of who up to twenty-one may suffer with dementia. There are 42 single rooms each with en-suite facilities. The home currently has two beds that are allocated for respite care. There is a choice of five sitting and dining areas, one of which is designated for smokers. There are four bathrooms and two shower rooms. There is a small seating area at the rear of the house, a steep path leads to a sloping grassed area and there is a paved patio area at the back of the garden. Vehicular access to the front of the building is restricted to emergency vehicles only, and a barrier is in place. Staff and visitor parking is at the rear of the building. The Grange is situated on a busy road near Wickford town centre with its shops and amenities. It is on a regular bus route and there are regular trains from Wickford Station. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of eight and a half hours. As it was carried out by two inspectors this equated to seventeen hours of input. The inspection mainly focused on the progress the home had made since the last inspection. Other standards were also considered. The home currently has an acting manager in place. The acting manager has worked at the home for some years before becoming the acting manager. An application to become the registered manager is being completed to be submitted to CSCI. A partial tour of the premises took place and care, staff and other records were selected at random and inspected. A number of residents and staff were spoken with. A notice was displayed in the main entrance area throughout the day advising all visitors to the home that an inspection was taking place with an open invitation to speak with an inspector. The acting manager was present throughout most of the day. A full and detailed ‘feedback was provided during and at the end of the inspection with opportunity for further discussion and/or clarification. A photocopy of the inspectors ‘premises audit’ and summary findings were provided to the home. What the service does well: What has improved since the last inspection? Since the previous inspection the home have been working to meet previous requirements and recommendations. The homes grounds have been improved to provide residents with a more useable space. A hairdresser’s room has been provided to enhance resident’s experience of this service. A small reminiscence area has been developed to provide enjoyment for residents. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 6 The home currently has no staffing vacancies, and so are not using any agency staff. This provides residents with care that is provided consistently by staff that they know. A member of staff has been employed to manage the putting away of residents clothing. This has meant that residents receive a better service and that clothing does not so frequently get lost/mixed up. Cupboards have been put up in some bathrooms so that items such as gloves can be stored more safely. 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. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 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 Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4, 5, 6. Prospective residents have their needs assessed before moving into the home. Staff at the home have received training in relevant areas to help them to meet residents assessed needs. EVIDENCE: Although not fully inspected at this visit, The Grange has a comprehensive statement of purpose and service users guide in place. These were on display in the homes lobby area. And copies were seen in many bedrooms around the home. The homes respite room contained ‘Welcome to The Grange’ information. The acting manager confirmed that prospective residents, including respite placements and residents moving into the home on an interim placements, are always visited, and have their needs assessed before moving into the home. Records of recently admitted residents showed that pre admission assessments had been well completed. The acting manager and staff spoken with showed a good knowledge and understanding of residents needs. Staff records and established staff spoken Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 9 with identified that in general appropriate and sufficient training is undertaken. Two members of staff spoken with confirmed that they had just completed an eight week training course in dementia care. The acting manager confirmed that residents and their families are encouraged to visit the home before moving in. Intermediate care is not provided at The Grange. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Resident’s health and care needs are well identified and planed for. Medication practices at the home are generally well managed and ensure that residents are kept safe. Development is however needed to ensure the safe management of creams and other topical applications. EVIDENCE: Residents spoken with felt that The Grange offered them good care. All residents at The Grange have an individual care file in place. A number of care plans were viewed as part of this inspection. These showed that resident’s health, care and social needs are identified and care planed for. Specific medical conditions were identified, and information available to staff to assist them in caring for residents. The good completion of care plans, and other documentation is largely due to the work of one member of staff. Some development is therefore needed to ensure that all staff contribute to and are fully aware of care planning information. Within the care planning system the home operates two assessment tools. A ‘mental status questionnaire’ and a ‘modified barthel index’ (based on physical care needs). The ‘scoring’ from these documents is at variance and does not provide a ‘holistic’ outcome in gauging resident’s dependency levels. For example a resident may have advanced dementia and present a number of Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 11 difficulties requiring a high level of staff input. At the same time they may be quite physically able. This has crucial implications on the way the home determines staffing levels, as current levels tend to be based on the ‘lower’ score that is normally associated with physical care needs. It is understood that the registered provider is aware of this anomaly and is reviewing practice. Care files evidenced that resident’s health care needs are monitored and met. Records showed that residents have access to all health care services. During the inspection it was identified that staff at the home undertake blood glucose monitoring for residents who are identified as having diabetes. This practice is not safe and places residents at potential risk. Proper staff training could not be evidenced, and it was stated that staff that have previously carried out the procedure, then train other staff. Clear protocols and residents consent to staff carrying out this procedure were not in place. Medication practices at the home are generally well managed and ensure that residents are kept safe. Medication records and profiles viewed were very clear and well organised. The home could not however evidence that it has PRN (as/when necessary) medication administration protocols in place. Also the management of creams and topical applications needs to be reviewed to ensure that residents are kept safe. Many pots and tubes of creams were noted in resident’s bedrooms and en suites. Sometimes there were several tubes of the same preparation with different dispensing dates. On one occasion cream belonging to a resident was found in another residents room. Throughout the day staff were noted to treat residents with courtesy and respect. On one occasion staff did not provide timely support to enable a resident to maintain their dignity. Apart from one occasion doors were kept shut when staff were assisting residents. These incidents were fed back to the acting manager. A pay phone is available, however the area where this is situated is now used as a lounge and dining area so does not provide privacy for residents. The positioning of this must therefore be reviewed. A number of residents have their own telephones in their bedrooms. The acting manager said that residents could also use the homes hands free telephone. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 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. Residents live in a stimulating environment where a range of different activities are on offer. Residents are free to exercise choice in their daily lives. EVIDENCE: The Grange has an enthusiastic activities co-ordinator in post. The Grange formerly had an active ‘Friends of The Grange’ group who also provided support and activities for residents. It is understood from the acting manager that this has now been disbanded, as many of its supporters are no longer available. A wide range of entertainment activities and outings are provided for residents on a regular basis. Up and coming events and activities are well advertised. Since the previous inspection a small reminiscence area has been developed to provide enjoyment for residents. Residents are able to follow their own routines. Residents are also encouraged to follow their own interests and hobbies such as knitting and sewing. On the day of inspection the home was nicely decorated ready for Christmas, and celebrations were planned. The home should try to ensure that the control of televisions and radios is in line with the wishes and preferences of all residents using communal areas. Visiting at the home is unrestricted to suit residents and visitors needs and routines. During the inspection visitors were noted to come and go freely. There is a lounge/visitors area where hot drinks can be made. This is also Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 13 used as a smoking area for residents, so may not be acceptable to some visitors. Resident’s can bring in their own possessions to personalise their rooms. Information on advocacy services was available. The home uses a four weekly rotating menu. Since the previous inspection a hot choice is now provided at teatime. There is a choice of menu at each meal. The home has several different dining areas for residents to use. They can also choose to eat in their rooms. One resident explained to the inspector that they had made specific choices about where and what they eat. This was reflected in their care plan. Tables were nicely laid for lunch. Residents mostly spoke favourably of the food provided by the home, although some issues were identified during the inspection: The fish pie serviced at lunchtime looked appetising but contained some bones, which could have been a hazard for residents. The pudding served on the day of inspection had been changed due to lack of appropriate supplies, but this had not been changed on the menu record. Due to a problem in the laundry area, there was insufficient protective clothing for residents to use. It was not clear that there were sufficient cakes available for all residents at teatime. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 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. The home has an established complaints procedure ensuring that residents and their families feel free to, and know how to raise concerns. Development is needed to ensure that staff have a clear awareness of adult protection procedures. EVIDENCE: The homes complaints procedure is on display in the homes lobby. Resident’s spoken with said that they would feel confident in raising concerns or issues with any of the staff. Complaints are recorded by the home. The system of recording needs to be reviewed to provide clarity and a clear record of complaints, and actions taken. The acting manager had an understanding of how to report and manage adult protection issues. However senior staff spoken with could not demonstrate that they had an adequate knowledge base and understanding of adult protection procedures. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 15 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, 20, 21, 22, 24, 26. The overall standard of the furnishings, décor and fitments within the home was good, and provided residents with a pleasant, homely and safe place to live. Development is however needed in some areas to ensure the comfort and safety of residents. EVIDENCE: All residents spoken with found the environment of the home pleasant. Since the previous inspection a large patio area with raised flowerbeds has been developed to improve the outdoor space for residents. The home was well maintained. A maintenance person is employed so that small jobs can be quickly actioned. The acting manager identified that regular premises and room audits take place. There are several lounges, dining and seating areas around the home. Residents can choose where they wish to sit. All areas were well lit and furnished. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 16 Toilets and bathrooms, containing assisted baths, are accessible to service users and clearly marked with pictures and words. All bedrooms have en-suite facilities. Since the previous inspection one bathroom has been decommissioned to provide a hairdressers room for the benefit of residents. This bathroom has been replaced by a shower room. This is waiting to be completed. Since the previous inspection cupboards have been placed in some bathrooms to provide safer storage for items such as disposable gloves. One bathroom was not fitted with a lock to provide for the privacy of residents. Appropriate moving and handling and pressure relieving equipment was noted around the home. The home is registered to provide care for up to twenty two residents who have dementia. Signage at the home to assist residents was satisfactory. Currently residents with dementia are accommodated in various areas of the home, and some health and safety issues were identified, relating to areas that residents could access that may put them at risk. This included the staff area and a sluice area. A specialist unit is being developed within the home. Particular attention will need to be paid to the environment and signage in this area to ensure that it is suitable. The Grange has no shared bedrooms. Residents spoken with said that they liked their rooms. Most were personalised with some of the residents’ own belongings. The home should consider the provision of appropriate mattress covers for the comfort of residents. At present, sheets are placed directly on the top of plastic covered mattresses. Resident’s rooms looked well cared for and beds were well made. The home employs a member of staff specifically to put residents washing away. This meant that resident’s draws and wardrobes were in the main tidy with clothes put neatly away. Apart from isolated pockets of odour, the home was generally clean and odour free. At the inspection the home was having difficulties as one of the washing machines was out of action. The homes laundry area was not therefore tidy. Cleanliness issues were identified. Dirty laundry was in close proximity to clean laundry. Areas behind machines had not been regularly cleaned. In addition items were stored in one of these areas creating a potential hazard. Both the kitchen and laundry areas of the home are secured with a keypad lock to protect residents. The inspection found a sluice door left unlocked and ajar. This could compromise resident safety. Although it was identified that some staff had completed training in infection control procedures, shortfalls in infection control/universal precautions practice were identified and fed back to the acting manager. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 17 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 Development is needed to make sure that residents are kept safe by all staff checks being completed/in place before staff start work at the home. New staff must receive a comprehensive induction to enable them to care properly for residents, and understand their needs. EVIDENCE: Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 18 Previous staffing levels at the home were. One senior and six care staff from 07.00 to 22.00. (with a decrease of one care staff from 14.45 to 16.00 in the afternoon.) One senior and two care staff at night. At this inspection the rota showed that the afternoon/evening staffing levels are now maintained (from 13.00) at five plus one. One member of staff rostered as a care assistant, works as a kitchen assistant for three hours of their shift. The acting managers hours (9 to 5 Monday to Friday) are supernumerary to these numbers. The acting manager must monitor staffing levels to ensure that they are sufficient to meet resident’s needs. This particularly to take into account the current non-holistic method off assessing resident’s dependency levels (see standard 7), Domestic and ancillary staff are employed. No domestic staff at the home work after 13.00 or 15.00. This must also be kept under review to ensure that this practice does not affect the service received by residents. The acting manager felt that current staffing levels were sufficient to meet resident’s needs. Residents at the home said that staff at the home are generally very good. It was reported that the home currently has no vacant hours and so use little agency staff. This provides greater consistency for residents. It was reported that two staff at the home have achieved NVQ level 3 and a further member of staff is undertaking this. Similarly two staff hold NVQ level 2 with a further member of staff undertaking this qualification. The staff files of three recently recruited staff were viewed. Files were well organised. Appropriate checks are undertaken in terms of checks on identification and references being taken up. It was however noted that staff were commencing duties in the home before a Criminal Records Bureau check of POVA first check was in place. This is not acceptable and has the potential to place residents at risk. Staff files did not demonstrate that staff were receiving a timely and comprehensive induction to assist them in caring properly for residents. No record of induction was available on two files. On another file only five out of 59 items had been signed off. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 37, 38. The registered provider has strategies in place to monitor the quality of service provided by the home. Practices in the kitchen need to be addressed. EVIDENCE: Not all aspects of these standards were assessed. The Grange has an acting manager in post who will be applying for registration with CSCI. The Grange provides opportunities to influence and express their views on the service they receive. Regular residents meetings are held, with minutes kept. A suggestions box is available in the homes lobby area. Regular staff meetings are also held. The registered provider has strategies in place to monitor the quality of the service provided. An annual audit of the service is conducted. This was very Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 20 detailed and included the use of questionnaires to gauge levels of satisfaction. The format needs development to make the information it contains readily available for residents and other interested parties. The registered provider also nominates an operations manager to conduct a monthly visit to the home to seek the views of people using the service, and make sure that the home is being managed correctly. Resident’s finances were sampled. These were satisfactory. However, currently residents can only access their monies, or other items that the home might hold for safekeeping, during office hours Monday to Friday. This is not stipulated in the Homes Service User Guide. Residents should be able to access their money or property at any time. Records at the home were in the main very well maintained. To ensure residents confidentiality books containing resident information should not be left accessible on the desk in the lobby area of the home. Issues relating to health and safety have been identified in this report and need to be addressed in order that residents are kept safe. On the day of inspection the kitchen area was not being managed in line with best practice. This related particularly to food storage. Freezers were untidy, and foodstuffs were not being dated when opened. Fire records and Records relating to the servicing of systems and equipment were satisfactory. Although training records were not examined in detail, it was reported that staff training in core areas is generally up to date with further training being planned for the new year. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 2 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 3 3 2 X 3 X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 2 Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 12 Requirement The registered person must conduct the home so as to promote and make proper provision to the health and welfare of residents. This refers to the need for staff to be properly trained and safeguards and consents to be in place in relation to any health care procedures. The registered person must make arrangement for the safe handling and management of medicines in the care home. This refers to the management of creams and topical applications. The registered person must ensure that the home is run in a manner that respects the privacy and dignity of residents. This refers to the incidents highlighted in the report/detailed to the acting manager. The registered person(s) must ensure that all staff are able to demonstrate competence on POVA reporting procedures. Timescale for action 01/01/06 2. OP9 13 01/01/06 3. OP10 12 01/02/06 4. OP18 13 01/02/06 Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 23 5. OP22 13 The registered person must ensure that all parts of the home are so far as reasonably practical free from hazards to resident safety. This refers to the need for the premises to be monitored to ensure that residents with dementia cannot access areas that may put them at risk. All bathrooms should be fitted with suitable locking devices to ensure the privacy of residents. The registered person must make suitable arrangements to prevent the spread of infection at the home and maintain the home in a clean and hygienic condition. This refers to the hygiene and universal precaution issues raised in the body of the report/detailed to the acting manager. Robust recruitment procedures must be maintained at all times. Previous requirement of 01/08/05 not met. 01/02/06 6. OP21 12 01/02/06 7. OP26OP38 13 01/02/06 8. OP29 18, 19 01/02/06 9. OP30 18 Staff must receive training for the work they are to undertake. Staff must receive robust induction training. The registered person must make suitable arrangements to maintain satisfactory standards in the care home. This refers to the need to review food storage practices in the kitchen area. 01/02/06 10. OP38 16 01/02/06 Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Refer to Standard OP7 OP9 OP10 OP15 OP16 OP22 OP27 OP28 OP30 OP35 Good Practice Recommendations All staff should be encouraged to be involved in the care planning process. The process of managing PRN medication should be reviewed and protocols be available in each case. The positioning of the homes pay phone should be reviewed so that residents can use it in private. Issues identified in the report and fed back to the acting manager relating to mealtimes/food should be addressed so that they do not re-occur. A clear ‘audit trail’ and record should be maintained for complaints. Consideration should be given to the provision of mattress covers for the comfort of residents. Staffing levels at the home should be kept under constant review to ensure that they are sufficient to meet resident’s needs and expectations. 50 of care staff should be trained to NVQ level two or above by 2005. Staff induction programmes should be in line with Skills for Care standards. Current practice relating to residents access to their monies should be reviewed. Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Grange (The) DS0000064578.V271899.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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