Inspection on 15/05/06 for The Homestead

This inspection was carried out on 15th May 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 Homestead 28/05/09

The Homestead 15/05/07

The Homestead 26/10/06

The Homestead 09/03/06

The Homestead 27/10/05

The Homestead 18/03/05

The Homestead 27/09/04

The Homestead 30/03/04

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 Homestead (The) 101 West Bay Road Bridport Dorset DT6 4AY Lead Inspector Sally Wernick Key Unannounced Inspection 15th May 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Homestead (The) Address 101 West Bay Road Bridport Dorset DT6 4AY 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) 01308 423338 SAME adrian.butler@whsmithnet.co.uk Mr Adrian Charles Winslow Butler Mrs Susan Patricia Butler Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th March 2006 Brief Description of the Service: The Homestead residential care home is registered to provide care and accommodation to a maximum of 13 older people over the age of 65 years. The home is owned and managed by Susan and Adrian Butler, who live on the premises with their family and occupy a private flat on the 2nd floor. The Homestead is situated halfway between the Market town of Bridport and the seaside resort of West Bay, approximately 1 mile from both places. The accommodation for residents is arranged over two floors in a substantial Georgian building. There is no passenger lift and therefore the home mainly accommodates people who retain sufficient mobility to manage stairs and/or manage to use the stair-lift. There are 11 single and one double bedroom. The Homestead is a pre-existing home (prior to implementation of National Minimum Standards) with 7 bedrooms providing space above 10 square metres and 5 with less than 10 square metres. There are bathing and toilet facilities on both floors and 4 single and the 1 double room have en suite toilet facilities. Communal rooms comprise a ground floor lounge and dining room. The home has a sunny and attractive ‘sensory’ garden to the front, with pleasant areas to sit, which is well used by service users in the warmer weather. The rear garden is steeply sloped, set to lawn with a vegetable patch which is rarely used by service users due to inaccessibility. A parking area is available for visitors at the front of the house. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and began at 10:00am on Monday, 15 May 2006. This was a ‘key inspection’ where the homes performance against the key National Minimum Standards was assessed alongside progress in meeting requirements made at the last inspection. A senior carer assisted the inspector, as did other members of care staff. The registered providers/manager were not present on the day of inspection. Methodology used included a tour of the premises, review of records and discussions with service users and staff. The inspector also reviewed the contact sheet for The Homestead and documentation submitted by the registered manager in response to a requirement made at the last inspection. The Commission for Social Care also sent questionnaires to the home for them to distribute amongst residents, relatives and visiting professionals. At the time of writing 6 questionnaires had been returned by community health providers two by Community care officers. Ten had been received from residents three from friends and relatives. A Pre-inspection questionnaire was also sent to the manager in order that information could be provided prior to the inspectors site visit. That information will be included in relevant sections of this report. What the service does well: Residents at The Homestead can be assured that they are provided with details about the care and services of the home prior to making a decision to move in. The Health and welfare of residents is promoted and maintained through contact with other health care professionals and residents are protected by the home’s policies and procedures for dealing with medicines. Residents spoken with confirmed that their right to privacy was respected and that staff treated them with courtesy and kindness. This was also observed during the course of the inspection. There is a range of activities each afternoon and residents choose whether they wish to take part. Friends and relatives are welcome at times that are flexible and residents are assisted to exercise personal autonomy and choice. Meals are appetising and of good quantity and quality. There are adult protection procedures in place and staff are aware of what action they should take if they are unhappy about any aspect of the service. There has been a programme of redecoration in place and for the most part the home is bright comfortable and hygienic. Standards of staff training are good and there is sufficient staff, on duty to meet the needs of residents. The Registered manager is a nurse and is well qualified in the field of social care. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 6 Questionnaires returned to the CSCI from other health professionals indicate that they have no major concerns about the care provided at the home. Responses from residents and their families are very favourable although for the 10 residents who were supplied with confidential, anonymous forms most came back identifying named residents. Some residents had been assisted by staff to complete the forms. In all aspects of care residents expressed satisfaction for example in response to the question: Do you receive the care and support you need? (answers –always, usually, sometimes, never). Nine respondents said “Always” one “Usually”. What has improved since the last inspection? 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. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 & 6 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experience of people using the service. The current service user guide does provide information about the care and services provided at The Homestead. Prospective residents are advised in writing that the home is able to meet their assessed need. The Homestead does not provide intermediate care standard 6 therefore is not applicable to this home. EVIDENCE: A review of the home’s service user guide revealed that it provides extensive detail about the home. Details of Internet access to inspection reports written by the Commission for Social Care however are not appropriate for the current service user group. In addition a copy of the most recent inspection report must be made accessible and readily available. Registration details are out of Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 9 date referring to the National Care Standards Commission instead of the Commission for Social Care this must be amended and the registered persons must supply an amended copy to each service user. Two care plans examined demonstrated that assessments of need are undertaken prior to admission and that prospective residents are advised in writing that the home is able to meet their assessed needs. Each service user is offered the opportunity to visit the home to meet staff and residents prior to making a decision about admission. There is also an initial four-week trial period. The Homestead does not provide intermediate care. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 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 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Care plans do provide useful information to staff about the needs of service users but they do not always demonstrate that the content is in accordance with service users wishes. Residents health and welfare needs are met in part through contact with other health professionals as required although risks to residents health and safety have not been sufficiently identified or acted upon. There are satisfactory arrangements in place for managing medication. Residents are respected and their right to privacy is supported. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 11 EVIDENCE: Four care plans were examined and whilst these were quite detailed there was no evidence of monthly review or consultation with service users. Where care plans had been reviewed and courses of action no longer relevant these had been scored through with pencil and new comments added. Risk assessments are in place however sufficient action has not yet been taken to manage identified risks for some residents. One assessment dated 04 identified the need for a radiator guard in one residents bedroom to prevent scalding or burning this was still not in place. Another resident reported that he had fallen out of bed on a number of occasions two of these incidents were reported in the accident book dating back to July and August of last year yet no assessment of this risk had been undertaken. Subsequent to the inspection the registered manager did forward to the inspector evidence of some residents involvement in their care plans and more detailed risk assessments. These demonstrated a clear understanding of residents needs and identified proper courses of action to be taken. Records and stocks of medication in the home evidence good practice and medication is managed in accordance with legal requirements. None of the residents currently self-medicate although in line with a requirement made at the last inspection risk assessments were established for those who wished to do so. Residents spoken to all reported that staff treated them with courtesy and respect at all times. Staff was observed to be kind and considerate throughout the inspection. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people who use the service. Entertainment and some recreational activities are provided that enable residents to enjoy some of their leisure time. Residents are supported in maintaining contact with their friends, family and the community and they are helped to exercise choice and control over their lives promoting independence. A varied diet is provided and in sufficient quantity to achieve a satisfactory response from residents. EVIDENCE: Residents spoken with confirmed that they have a choice in all routines of daily living and confirmed there was sufficient stimulation in the home. It was evident that there is a good relationship between staff and residents and there is a programme of activities each afternoon, which includes games “theme days” and use of the “memory box”. Family and friends are made welcome and are able to visit at times which are flexible. Where practicable residents are able to bring personal possessions into the home and are encouraged to Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 13 manage their own affairs for as long as they are able to do so. Pets are accommodated and can live with residents in their rooms again if practical. A varied diet is provided and individual tastes can be accommodated at meal times. For example one resident prefers beans on toast for breakfast and staff tell me that efforts are made to provide residents with “what they fancy”. There is always a cooked lunch teatime offers a variety of snacks and sandwiches. Food is fresh although one resident did feel there was “a lack of variety”. Roast beef was served on the day of the inspection with strawberry tart for dessert. Most residents eat in the dining room although some do prefer the privacy of their rooms. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Information about the complaints procedure is not sufficiently well displayed to ensure that service users have access to it should the need arise. The adult protection procedure does contain the necessary information to enable staff to take appropriate action, in the event of an allegation of abuse. EVIDENCE: Service users confirm that they feel able to raise any issues or concerns with the registered manager or with staff and there is a written complaints procedure. A complaints and compliments book is kept in reception however this did not include details of any concerns expressed over the last five years and no evidence of review. The pre- inspection questionnaire completed by the Registered manager indicates that no complaints have been received during the last inspection period. It is considered good practice for the home to record complaints and to demonstrate how these have been actioned for the benefit of the residents. There is an adult protection policy/procedure and staff, confirm that they have received relevant training. Staff, spoken to was aware of what action to take if concerns were expressed by or on behalf of residents. A large proportion of staff has received approved adult protection training one example of the homes good practice. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 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, 25 & 26 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Recent investment in redecoration has improved the appearance of the home creating a more pleasant environment for those living there. However, the comfort and dignity of one resident is compromised by the declining presentation of the accommodation. Failure to maintain the environment sufficiently well compromises the safety and well being of residents. The heating and water systems could place residents at risk. The home is generally clean pleasant and hygienic. EVIDENCE: Previous inspections have highlighted the need for radiator guards and pre-set valves with fail safe devices to be fitted. Residents however continue to be Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 16 presented with hazards in the form of hot water and radiators, which may lead to accidental scalding. Individual wash hand basins were found to be of hot water temperature. It is a requirement therefore that, individual risk assessments be undertaken for all residents and steps taken to achieve safe temperatures by taking the necessary measures. The registered persons must produce a schedule of maintenance demonstrating timescales for completion of works and this should be forwarded to the Commission. In addition it is recommended that a first floor door leading to a staff staircase be clearly marked as staff only. This is deemed necessary to safeguard the welfare of residents. Subsequent to the inspection a programme of maintenance was forwarded to the commission, which stated that a number of works had already been completed. A requirement at the previous inspection highlighted the need for heating to be monitored to ensure that satisfactory levels are achieved during night hours. In the absence of the registered manager evidence of this could not be provided although residents reported that they are generally comfortable. This requirement will remain and will be reviewed at the next inspection. A recent programme of refurbishment is evident rooms are well decorated and newly painted and bathrooms are clean and brightly lit. One residents room however, was found to have very “tired furnishings “ with torn net curtains a very dated television and a divan bed which was soiled. A chair was placed by the resident at the side of the bed to prevent him falling caused he stated by him slipping from the plastic covering on the mattress. This presents an unnecessary risk to the service user and steps should be taken to address this through immediate risk assessment (see requirement). In one residents’ room it was found a hoist was stored. Staff on duty stated that the resident did not use the hoist although the registered manager subsequently refuted this by letter. Bedrooms should not be used for storage space and the hoist removed immediately if not in use. In line with a recommendation made at the two previous inspections steps have been taken by the registered providers to fit bedroom doors with approved locks. Residents however, have indicated that they do not wish for this to happen and have signed to that effect. All staff has completed training in infection control and the premises appear clean, hygienic and free from offensive odours. The home does not have any sluice facilities however risk assessments were forwarded to the commission for social care following the inspection and the current procedures are adequate. It would be good practice to provide disposable towels for both staff and residents in all washroom areas as the current arrangement may increase the risk of infection amongst the resident and staff group. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The home employs sufficient staff to ensure the needs of residents can be satisfactorily met. Recruitment and employment practices have improved to minimise the risk of unsuitable staff being employed. The owners and staff at the Homestead are committed to a programme of formal training designed to improve their knowledge and skills for the benefit of people living at the home. EVIDENCE: Staffing ratios at the Homestead are sufficient to meet resident’s needs and staff, are seen as kind and patient. There were three members of staff on duty on the day of the inspection the senior carer confirmed that this is normal practice. A comprehensive programme of training is implemented and a training matrix demonstrates planned and completed training for all members of staff. Staff themselves commented that the training was excellent and felt that they were afforded many learning opportunities both for the benefit of themselves and service users. Five members of the staff team have completed NVQ 2; seven Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 18 are currently studying for that qualification two of which have almost completed. There is a very good culture of learning within the home and the two staff members spoken to were very well motivated and keen to demonstrate good practice. The previous inspection identified some shortfalls in the recruitment process written documentation from the registered manager however, confirms that appropriate steps have been taken and practice has improved. Staff records were not available for inspection during the site visit the registered providers are reminded that documentation must be available at all times. Information included on the pre-inspection questionnaire confirms that, no new members of staff have been employed since records were last examined. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 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, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The registered manager is experienced in care and provides clear leadership throughout the home with staff demonstrating an awareness of their roles and responsibilities. Quality Assurance methods were not available on the day of inspection the home is not therefore in a position to demonstrate that there is an on-going review of aims and outcomes for service users. Resident’s financial interests are safeguarded. The home generally follows practices that promote and safeguard the health, safety and welfare of service users. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 20 EVIDENCE: Mrs Butler has achieved the Registered Managers Award; she is experienced in care and also undertakes up to date vocational training alongside other members of staff. Staff, were unable to provide the inspector with details of the homes quality assurance programme and residents spoken to were not able to identify ways in which they were able to formally express their views. There is no record of residents meetings and it is not clear how the views of family friends and stakeholders are sought. Subsequent to the inspection however documents were forwarded to the commission for social care, which demonstrate that the home’s providers undertake regular self-evaluation with action plans for improvement. There is also an annual Development plan for 04/05 and a number of questionnaires for residents seeking their views on quality of life within the home however these were not dated or completed. These will be more formally reviewed at the next inspection. The home does not have responsibility for resident’s finances. Friends, relatives or advocates support those that are unwilling or unable to handle their own affairs. Examination of records of testing and maintenance of fire fighting equipment, alarm systems and emergency lighting demonstrated that these are undertaken at the required intervals. The record of fire drills and evacuations is combined and demonstrated when these occurred. The registered manager ensures safe working practices by facilitating attendance for staff at the full range of Health and Safety training including moving and handling, fire safety first aid food hygiene and infection control. The Health and Safety of residents remains compromised however by the current heating and water systems. Requirements regarding safe working practices (standard38) have been made under standards 25. Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 X X X X X 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 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. Standard Regulation Requirement The Registered Persons must supply a copy of the service user guide to each service user; this must contain up-to –date CSCI registration details. A copy of the most recent inspection report must be accessible and readily available to service users. All service users must have a full, comprehensive and up to date individualised plan of care that must be followed in order that care needs can be met and risks reduced or eliminated. Service users must be consulted with regard to decision-making, processes of assessment and care planning. The registered persons must ensure that all residents have a robust, individual assessment of any risks of accidental scalding posed by unguarded radiators and hot water. Risk assessments must address individual considerations including the person’s mobility, history of falls, confusion and their levels of understanding if they are physically independent. Action to be taken by staff to ensure risks are reduced or eliminated must DS0000026822.V294190.R01.S.doc Timescale for action 1. OP9 4&5 15/06/06 2. OP25 14&15 15/06/06 3. OP29 13 15/07/06 Homestead (The) Version 5.2 Page 23 4. OP29 13 5. OP25 23 be explicit and all assessment and care planning must be available for staff reference. The registered person must produce a schedule of maintenance demonstrating time-scales for completion of works including radiator guards and hot water regulators. Radiators must be subsequently guarded and hot water regulated. The registered persons must ensure that satisfactory heating levels are achieved during night hours to meet resident’s needs; checks should be made to ensure heating levels are maintained. 15/06/06 15/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard OP16 Good Practice Recommendations All complaints and concerns should be contained in one record these should include details of investigation and any action taken and should be audited at required intervals. Peeling wallpaper should be satisfactorily repaired or rooms redecorated. Not met from 27/10/05 It is strongly recommended to prevent the spread of infection that staff and residents be provided with disposable towels in bathroom and communal washing areas. Work should be undertaken on the homes quality assurance systems so that it can be clearly demonstrated that residents and stakeholder consultation has taken place and is responded to and that the home is meeting is stated aims and objectives 1. 2. OP19 3. OP19 4. OP33 Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Homestead (The) DS0000026822.V294190.R01.S.doc Version 5.2 Page 25 - 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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