Inspection on 23/03/06 for The Green Home for Older People

This inspection was carried out on 23rd March 2006.

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

The inspector 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 Green Home for Older People 02/01/07

The Green Home for Older People 06/09/05

The Green Home for Older People 11/01/05

The Green Home for Older People 10/08/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The Green Home for Older People Seacroft Green Leeds LS14 6JL Lead Inspector Dawn Navesey Unannounced Inspection 23rd March 2006 9:30am 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 Green Home for Older People DS0000033270.V271635.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. The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Green Home for Older People Address Seacroft Green Leeds LS14 6JL 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) 0113 2144166 Leeds City Council Department of Social Services Miss Michaela Jayne Conoby Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: The Green Home for Older People provides personal care, without nursing, for 37 residents in a purpose built two storey building in the heart of Seacroft, a suburb of Leeds. There is an adjoining day centre, which is independent of the home and is not regulated, therefore was not part of this inspection. Accommodation for residents is in single rooms on two floors. There is a lift for those unable to climb stairs. Bedrooms and bathrooms are arranged in small units with communal open-plan sitting and dining areas on both floors. Local facilities including shops, pubs and public transport are within easy reach of the home. The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, care homes have a minimum of two inspections a year; these may be announced or unannounced. The last inspection was announced and took place on the 6th September 2005. The purpose of this inspection was to monitor progress in meeting the requirements and recommendations made at the last inspection and to look at the standard of care for people living in the home. The people who live in the home prefer the term resident; therefore this will be used throughout the report. The inspection was carried out by two inspectors between 9-30am – 5-45pm. During the inspection we looked at records, we observed staff carrying out their work and spoke with residents, staff and a District Nurse who was visiting the home. Some feedback at the end of the inspection was given to the peripatetic manager and also to the senior care officer on duty. The registered manager of the home was on holiday. Comment cards/questionnaires are left for residents, visitors and other professionals at each inspection. These provide an opportunity for people to share their views of the home with the Commission for Social Care Inspection (CSCI). Comments received in this way are shared with the provider and /or the manager, without revealing the identity of those completing them. Since the last inspection a number have been returned, all giving positive comments about The Green. What the service does well: Residents are encouraged to maintain their independence and exercise choice and control in their lives. This is especially noticeable around meals and mealtimes. Residents said they liked the food at the home and they can make choices from the menu. One resident said “you don’t want for anything here and there’s always second helpings”. Where staff assist residents, it is done discreetly and properly. A resident said “they are so kind here”. The home has a relaxed atmosphere and there is great rapport and communication between residents and staff. Staff said that they had time to talk to residents and get to know them. One resident said “ we are like one big happy family”. Another said “it’s great here, much better than the last place”. There is an excellent range of activities on offer, which have included residents celebrating Valentines Day and St. Patrick’s night. On the day of the visit residents were making Easter bonnets. The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 6 Communication between the home and visiting professionals such as GPs and Community nurses is very good. The District Nurse said “all staff know what they are doing and why”. The home has a good Quality Assurance questionnaire. Comments from GPs included “carers are warm and supportive and know the residents well”, “staff take notice of my recommendations and assessments”, “from a medical perspective the home appears to be well run”. What has improved since the last inspection? What they could do better: Pre-admission assessments must be completed for all new residents. Care plans must be developed further so that staff have more detailed information about all of the residents’ care and support needs. Care plans must be reviewed to make sure the plan is still meeting the person’s needs. Staff should take care when making daily notes so that records give an actual description of behaviours. Night staffing levels must increase to safeguard residents and staff. Staff must follow proper hygiene procedures to prevent the spread of infection. There must be a Criminal Record Bureau (CRB) check for existing staff. The home must address a number of health and safety issues, such as, making sure that fire exits are not obstructed, repairing or replacing the wrinkled hall carpet and replacing a number of rusty tubular framed commodes. Staff must be properly supervised to make sure the needs of residents are being met. All staff should receive training on adult abuse so that residents are protected. The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 7 A number of requirements and recommendations have been made to address these issues. They can be found at the end of the report. 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 Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Residents and their relatives are able to make informed decisions before moving in, however pre-admission assessments must take place to make sure the home can meet assessed needs. EVIDENCE: A resident, who had recently transferred from another home, did not have any pre-admission assessment information on file and there was no evidence that this had taken place. However, this resident said he had made an informed choice about moving into the home. The Green Home for Older People DS0000033270.V271635.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 and 8 Residents’ care plans require further work so that staff have clear information on how to meet the needs of residents. Health care needs are met and support is arranged to suit individuals. EVIDENCE: A number of care plans were looked at. These are called Lifestyle Plans giving details of residents care and support needs, preferences and past history. Health care needs are also identified and on-going health records are kept. Staff described the level of care given but this was not reflected in the care plans. Information such as “needs assistance with bathing” and “wears incontinence pads” do not give staff enough information on how the resident needs assistance or what type of pads are used. One resident was using a pressure relieving mattress but there was no care plan in place on how to manage pressure area care. Another resident had a history of reduced mobility, there was no care plan to say how this was being managed and no risk assessment in place for the prevention of falls. A resident who was underweight did not have an up to date nutritional assessment or an up to The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 11 date assessment of pressure area care. Plans were signed by keyworkers and residents, but had not been reviewed monthly. Resident’s daily records were written using terms such as “smashing mood”, “mischievous” and “pleasant lady”. This does not accurately describe residents’ behaviours. Abbreviations were used in the daily records and the term “commoded” was used when a resident had been assisted to use a commode. The notes also often had written in them, “assistance given”. This does not specify what assistance was given to the resident. Some risk assessments were in place, for example, falls and choking. However other risks relating to scalds or nutrition were not in place. Requirements and recommendations have been made to address these issues. During the inspection a District Nurse visited the home twice to attend to health care needs of residents. She said that systems are in place to ensure good communication between the staff at the home and health professionals. A GP holds a weekly surgery for residents within the home, the District nurse said this works very well and again increases communication. Good records are kept of residents who had dental, optical or chiropody treatment. The Green Home for Older People DS0000033270.V271635.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): 14 and 15 Residents are encouraged to maintain their independence and therefore take control of their lives. Residents have a well-balanced and nutritious diet. EVIDENCE: Residents said they liked the food at the home and they can make choices from the menu. A three weekly menu plan is used, showing plenty of variety. The chef said he attends residents’ meetings to find out people’s choices and gain comments on the food and menus. There are plans to change the menus in response to residents’ requests. Snacks are available all day, as is tea, coffee and juice. These are all served from kitchenettes in each unit of the home. The lunch-time meal was relaxed. Residents sat in small groups, which allowed them to chat and to help and support each other. Vegetables were served in tureens and gravy in a gravy boat. This helped residents to have control over portion sizes as well as helping them to maintain a good level of independence. When assistance from staff was needed, this was given discreetly and sensitively. Staff knew about the importance of residents The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 13 keeping their independence in order to take control of their lives, and always asked residents if they wanted help before giving it. If preferred, residents could have their meals in their own rooms. Staff prepared an attractive tray with a tray cloth, condiments and serviette. Residents said they could ask for alternatives to what was on the menu, this was confirmed by the chef and was seen to happen at lunch- time. A cooked breakfast is available as a choice from the menu everyday. The Green Home for Older People DS0000033270.V271635.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): These standards were not assessed at this visit EVIDENCE: The Green Home for Older People DS0000033270.V271635.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, 24 and 26 Residents live in a safe, pleasant, well- maintained environment both inside the home and outdoors. Some practices increase the risk of the spread of infection. EVIDENCE: The home has a good standard of décor and is warm and well maintained. Some bathrooms have recently been refurbished and one resident spoke of his delight at the new showers. Bedrooms are all single use and are comfortable, homely and personalised. It was evident that residents had brought their own pieces of furniture in with them. One resident said she had brought her own bed in with her. Another resident who said she was a bit chilly had this seen to straight away when staff closed an open window. Each unit within the home has its own dining and sitting area. These areas were personalised with some items of furniture being of an “older era” such as The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 16 a 1940’s display cabinet and table. There is a lounge where residents can have private time and eat with their visitors and a bar area where residents can enjoy social activities. The grounds are extremely well maintained. One of the residents looks after the garden and has great skills in this. He has kept the flower beds and rockeries going throughout the winter months and told us of his plans for spring planting. He told us how much he enjoys this role and was very busy on the day of the visit with his work. Repairs are dealt with promptly. On the day of the visit the dishwasher had broken down. This was reported and fixed during the course of the visit. A visit from the Fire Officer had been carried out in November 2005, with some recommendations made. The Manager had responded to these recommendations, however as she was not on duty during the visit, we were unable to check on progress made. A requirement has been made to address this. The kitchen was clean and tidy. Cleaning schedules were in place with tasks signed for. All staff wore protective clothing before entering the kitchen area. There were a number of issues regarding infection control. Staff said they wear gloves and aprons when taking residents to the toilet, however, they said that both aprons and gloves are only worn when assisting someone with incontinence and that just gloves are worn on other occasions. Aprons must also be worn. A staff member was seen assisting a resident to the toilet in an apron being worn for serving food. This is not acceptable. Some protective clothing for kitchen staff was being stored in the staff toilet, this also increases the chances of cross infection. Soiled linen is hand sluiced before being to being taken to the laundry. This practice increases the risk of infection. The sluicing area has no clinical waste bin; staff said they use the nearest toilet or bathroom bin to dispose of their aprons and gloves. The laundry room had no clinical waste bin, the walls did not look clean and one area of the wall had tiles missing. A number of commodes had rusty tubular frames. These need replacing. Domestic staff described systems for reducing the spread of infection such as the use of colour coded cleaning cloths and wearing protective clothing when cleaning. Some bathrooms and toilets did not have clinical waste bins and no facilities for the double wrapping of soiled incontinence pads. The newly refurbished bathrooms did not have liquid soap or paper towels. The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 17 Requirements have been made to address the above issues. The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 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 and 30 Night staffing levels are inadequate for the number of residents. Recruitment procedures do not always protect service users. Staff are trained and competent to carry out their jobs. EVIDENCE: The home is set out in small units over two floors. With this layout and the number of residents, the current staffing level of two staff at night is not enough. Accident records showed that during March, 10 out of 11 accidents occurred at night or in the early hours of the morning. Minutes of a staff meeting showed how staff who work nights had expressed their concerns of feeling vulnerable when on nights with just two staff across the units. This issue was made a requirement at the last visit. The response to this was that the situation would be monitored. No evidence of this was found. A requirement has been made again. 3 recruitment records were sampled. Application forms and references were seen but there was no CRB for one member of staff. All staff must have a current CRB check carried out. Although all staff had had a photograph on file, some were originals and some were photocopies, which at times can be difficult to distinguish. The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 19 A requirement and recommendation have been made to address this. Staff said they had completed a comprehensive induction programme, which included infection control, First Aid and moving and handling. They also said that they had attended training on meeting the needs of people with dementia. Training records and the home’s induction training booklet gave details of the training available. Care, kitchen and domestic staff on duty were aware of what to do if they suspected abuse, but they have not attended any formal training on adult abuse. Minutes of a staff meeting showed that abuse had been discussed and the manager planned to discuss this further in supervision with all staff. It would be good practice for all staff, including catering and domestic staff, to access some formal training on abuse. A recommendation has been made. Over 50 of the staff have achieved, or are working towards a National Vocational Qualification. The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 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): 31 33, 35, 36 and 38 The home is well-managed, the interests of the residents are seen as important to the manager and staff. Staff are not always properly supervised. Some working practices do not promote health and safety. EVIDENCE: The Manager is currently working on the Registered Managers’ Award. We were unable to check on progress as the Manager was not on duty and her staff file was not available for inspection. There is a Quality Assurance questionnaire in place, which asks for comments from residents, relatives, professional visitors to the home and staff. The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 21 There was evidence that staff meetings take place and residents’ views are respected and acted upon. The minutes of a recent meeting showed that a resident had asked that the flavour of soup was written on the menu. This was carried out. Monthly regulation 26 visits are carried out. The financial procedures in the home make sure that each resident’s money is kept separately. Residents have access to their money at all times. One resident was seen asking about her money and staff responded to her with an answer. The property book currently used does not state clearly enough where resident’s’ property is stored. A recommendation has been made. There was a staff supervision plan on the office wall but some staff, particularly night staff, had not received regular supervision or had annual appraisals. However, the Manager had a plan in place to address this. Accident reports are completed for any accidents or incidents. It would be good practice for the form to have space to write when residents were last seen and by whom and a space for any follow up or outcome of the accident. A system, should be put in place to enable analysis of accidents so that patterns and trends can be identified. A recommendation has been made regarding this. A number of health and safety issues were seen such as, a wrinkled carpet in the hallway, a blocked fire exit and a clothes rail outside the laundry partially blocking a fire exit. A resident who was smoking let the cigarette burn down into her hand and she did not use the ashtray. The carpet around her chair had cigarette burns in and the District Nurse said she had previously damaged two pressure relieving cushions with cigarette burns. Requirements have been made to address these issues. The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 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 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x x x 2 STAFFING Standard No Score 27 1 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 2 x 2 The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 23 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 OP3 Regulation 14 Requirement Pre-admission assessments must be carried out to demonstrate how the home can meet assessed needs. Care plans, linked to assessments, must show in detail the individual care and support needs of residents to make sure staff provide person centred care. Timescale for action 31/05/06 2. OP7 15 30/06/06 3. OP9 13 This is outstanding from the previous inspection. Any resident who self medicates 31/05/06 must have a risk assessment showing factors taken into account regarding their ability to hold medication and their understanding of the process. Systems and procedures must be in place showing measures taken to ensure compliance and to review the process. This is carried forward from the previous inspection. The registered manager must forward an action plan to CSCI detailing progress on the funding DS0000033270.V271635.R01.S.doc 4 OP19 13 31/05/06 The Green Home for Older People Version 5.0 Page 24 5 OP26 13 application to carry out schedule 2 recommended fire safety work, identified in the fire officer’s report of November 2005. Aprons and gloves must be worn when assisting residents at the toilet. Staff must not assist residents to the toilet while wearing protective aprons for serving food. Kitchen staff must not store protective clothing in the staff toilet. Clinical waste bins must be provided in all bathrooms and toilets along with a supply of gloves and aprons. Liquid soap and paper towels must be provided in all bathrooms and toilets. The practice of hand sluicing of soiled linen must cease. The home must use water-soluble bags when transferring soiled linen. Missing tiles in the laundry must be replaced. The home must make sure that at all times there are staff in such numbers as are appropriate for the layout of the building and the number of residents. 31/05/06 6 OP27 18 30/05/06 7 8 OP29 OP36 19 18 This is outstanding from the previous inspection. The manager must ensure a 31/05/06 Criminal Records Bureau check is carried out for all existing staff. All staff, including night staff, 31/05/06 must be appropriately supervised and receive formal DS0000033270.V271635.R01.S.doc Version 5.0 Page 25 The Green Home for Older People 9 OP38 13 supervision at least 6 times per year The wrinkled carpet in the hallway must be repaired or replaced. Rusted commodes must be replaced. Risk assessments must be carried out for residents who smoke and appropriate measures put into place to minimise risks. All fire exits must be kept clear and free of obstructions. 30/06/06 10 OP38 13 30/04/06 11 OP38 13 24/03/06 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 OP7 OP9 Good Practice Recommendations Terms such as “smashing” and “pleasant” or activities described as “commoded” should be replaced with descriptions of actual behaviours and support given. Policies and procedures should be revised and updated in line with guidelines from the Royal Pharmaceutical Society. This should include a policy and procedure relating to homely remedies. This is carried forward from the previous inspection. An original photograph should be kept on file in the home for all staff. All staff should receive training on abuse. The system for recording property held on behalf of residents should be reviewed. Accident records should be analysed in order that patterns and trends can be identified. Accident reports should have details of when residents were last seen and by whom. There should also be a section for any follow up or outcome of the accident . 3 4 5 6 OP29 OP30 OP35 OP38 The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Green Home for Older People DS0000033270.V271635.R01.S.doc Version 5.0 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. 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