Inspection on 09/05/07 for The Laurels, Huntley

This inspection was carried out on 9th May 2007.

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 Laurels, Huntley 29/08/06

The Laurels, Huntley 30/11/05

The Laurels, Huntley 08/06/05

The Laurels, Huntley 17/11/04

The Laurels, Huntley 08/06/04

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 The Laurels Main Road Huntley Glos GL19 3EA Lead Inspector Sharon Hayward-Wright Key Unannounced Inspection 9th May 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Laurels Address Main Road Huntley Glos GL19 3EA 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) 01452 831484 01452 830604 Mrs Patricia Alice McCreery Mrs Patricia Alice McCreery Care Home 8 Category(ies) of Old age, not falling within any other category registration, with number (8) of places The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2006 Brief Description of the Service: The Laurels is a comfortable well-maintained Care Home providing personal care for eight people who are aged 65 years and over. The house is situated on the A40 in the village of Huntley, approximately 6 miles from the City of Gloucester. The eight single bedrooms, five with en suite facilities, are located on the ground floor, with toilets, shower and assisted bathing facilities within easy access. A lounge/dining room is provided for the use of people living at the home. They also have the benefit of a small private garden at the rear of the house. The proprietor and her family live in the property; the Registered Manager/Provider provides overnight cover for the Home. All the bedrooms are equipped with emergency call facilities. The fees range from £390 to £425. Extras to this include hairdressing and chiropody. The home does not display copies of their Statement of Purpose/Service Users’ Guide. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector carried out this inspection on one day in May 2007. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes in to account the views and experiences of people using the service. The Registered Manager/Provider was available during the inspection as were other members of the home team. A total of 24 standards were inspected. Several people living at the home were spoken with to ascertain their views on the care and services provided. A number of surveys were sent to the home prior to the inspection to obtain the views of both people living there and visitors to the home. The comments received from the surveys and from speaking to people during the inspection have been used in the report. The comments received from people living at the home during the inspection all indicated they are very happy living at the home. The Registered Manager and care staff were spoken with throughout the inspection and were helpful and co-operative. Feed back on the inspection findings were given on completion and were received in a constructive and positive way by the Registered Manager/Provider. Two requirements had not been complied with since the last inspection. On this occasion the timescales have been extended as indicated in the requirements made. Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the revised timescale may lead the Commission for Social Care Inspection to considering enforcement action to secure compliance. What the service does well: The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 6 The home is a small family run home that all people living there said is very homely and a comfortable place to live. People live in a well maintained home that is always cleaned to high standards. The people living at the home said they have a good relationship with the staff and the staff demonstrated good awareness of their needs. People living at the home are able to have input into the meals provided allowing both choice and variety and the home is able to cater for people who require a special diet. What has improved since the last inspection? What they could do better: The home must improvement their recruitment practices as they could potentially place people living at the home at risk. Training for staff needs to be improved to ensure they have the necessary skills to care for the people living at the home. The home should consider reviewing whether they provide activities for people living at the home who are not able to get and about. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 7 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 summary of this inspection report can be made available in other formats on request. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 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 Laurels DS0000016615.V337811.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose/Service Users’ Guide provides people with information abut the services offered, however this can be further improved by adding additional information. Arrangements for admission procedures are in place and this includes a full assessment of needs completed prior to the person moving in and assurance that their needs can be met. EVIDENCE: Following the last inspection the home needed to make additions to their Statement of Purpose/Service Users’ Guide; this has been addressed. However consideration should be given to the home adding information about their night staff arrangements to enable prospective people to have sufficient information to make a decision about whether the home is suitable to meet their needs. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 10 The Registered Manager/Provider said that she is going to display a copy of their guide in the entrance to the home. The home should ensure that their Statement of Purpose/Service Users’ Guide is up to date following the implementation of new Care Home Regulations that came into force in September 2006. A survey received from a person in the home had ticked to say they had received enough information about the home prior to moving in. Since the last inspection several people have moved into the home. The assessments of three of these people were examined. All had an assessment completed by the home prior to admission, however one of these assessments was not dated when completed. One person had an assessment completed by Community and Adult Care Directorate (CACD) and discharge information from the hospital staff was also available. The Registered Manager/Provider now sends a letter to prospective people stating the home can meet their needs, however this has not been done for the recently admitted person. The Registered Manager/Provider said she would attend to this. A person who had recently moved into the home confirmed that they had visited the home prior to moving in with a friend. They also said that the home has a good reputation in the local community. Intermediate care is not provided in this home. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. 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 using available evidence including a visit to this service. Improvements have been made with the care planning processes used by the home, however further progress can be made by adding additional information. Since the last inspection the home has made progress with their medication systems and with extra improvements the home can further minimise the risks to people living there. EVIDENCE: The care of two people was examined in detail and this included reading care records, speaking to the person where able and speaking to staff. Both people had moved into the home since the last inspection. Both had an assessment of needs completed prior to moving in by the home and one person had one completed by CACD. The home had an ongoing assessment of needs for each person that is reviewed frequently. Each assessment contained information about each person but could benefit from more detail in places. Following the last inspection the home has included detailed care plans for individual The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 12 problems. On reading one person’s daily records it indicated that at times they were wandering around the home and no care plan was in place for this. This was discussed with the Registered Manager/Provider who said she would address this. In the care plans examined there was no evidence that people living in the home are involved in this process. However at the last inspection evidence was seen of people’s involvement in care records. Moving and handling assessments were seen and these are reviewed frequently. Records relating to personal care and activities are also maintained. Two surveys returned from a people living at the home said they ‘usually’ receive the care and support they need. Of the three surveys returned from relatives/visitors to the home, two said the home ‘usually’ meets the needs of their relative/friend and one said ‘always’ meet the needs of their relative/friend. Evidence was seen of health professional visits in people’s care records. This includes GPs, continence nurse and optician. A Community Psychiatric nurse rang the home during the inspection. One of the surveys returned by a person living at the home said they ‘always’ receive the medical support they need. Medication systems used by the home were examined. The staff hand write all Medication Administration Records (MAR) and these are all checked and signed by another member of staff. Records were seen for medication received into the home, administered and where necessary returned to the local pharmacy. The Registered Manager/Provider said that all staff that administers medication has undertaken training. Since the last inspection the Commission’s Pharmacist visited the home to provide advice about the medication systems used and following this the procedure has been changed for administration. To further improve this and to reduce any risks to people at the home consideration should be given to taking the box with medication in to the person before administering with the Medication Administration Record. The home does no have any person who is taking controlled medication. A record book is in place to record these if needed. At the time of the inspection no person was self-administering their medication. The temperature of the room where medication is stored is now monitored. One person needs to have a protocol in place for how to deal with ‘wasp stings’ and people who are taking ‘prn’ or ‘as and when required’ need to have care plans devised. The Registered Manager/Provider has reviewed their medication policy, however this was not checked in detail at this visit. The fridge that is used for storing medication has broken and from discussions with the Registered Manager/Provider they have minimal medications that need to be stored, only eye drops. The home can purchase a lockable facility that will fit into their fridge to store minimal medication in. If creams and eye The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 13 drops were needed to be stored in fridge then a separate lockable containers would be required. The medication ordering system used was discussed. Privacy and dignity was discussed with one person and they had no concerns about this and felt the staff treat them well. Several people said they have their own telephone in their room. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have the opportunity to undertake their own activities programme, however the people could benefit from input by the home to improve their recreational interests. People living at the home receive a varied diet based on their choices. EVIDENCE: The home does not have a structured activities programme as several people living at the home are able to plan their own. One person was out on the day of the inspection. People spoken with said that a library van visits the home about every six weeks and they can chose their own books. Families also take their relatives out and where able people can go outside for walks. One person had a ‘life history’ completed and this was discussed with them. One person had commented on their survey that the home ‘never’ has any activities they can take part in. Consideration should now be given to reviewing this practice of not having a planned activities programme, as people at the home may not The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 15 be able to go out as much and several people have medical conditions which may benefit from input from the staff in this area. The Registered Manager/Provider said she is looking into trying to arrange day trips out. One person visits the church frequently but it was unclear about how other people at the home who are not able to get out make arrangements. As another person, prior to moving into the home went to church several times a day. After lunch a number of people were sat talking in their lounge. The Registered Manager/Provider confirmed that visiting to the home is not restricted. People living at the home confirmed they have visitors at a time convenient to their visitors. One person attends a day centre. People living at the home confirmed that are able to make choices about their daily lives within the constraints of living in a care home. Mealtimes tend to be set but outside of this people said they can make choices. Evidence was seen in one person’s care records of help from an advocate. In rooms belonging to people at the home they had their own possessions displayed. The cook explained that the home works on a three-week menu rotation, which is devised by the Registered Manager/Provider with input from people living at the home. People confirmed that at their yearly meeting they are asked what they like on the menu. Comments received at the inspection said they were all very happy with the food provided. One person had commented on their survey that they ‘always’ like the meals in the home. Food records are maintained of food provided that is additional to the menus. A mealtime was not observed at this inspection. Hot drinks were seen being given out to people who confirmed they are offered drinks throughout the day. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure in place that assures people who live at the home and visit that their concerns will be listened to and acted upon. Arrangements for protecting service users from possible risk of harm and have been improved since the last inspection. EVIDENCE: A copy of complaints policy is on display by the main entrance to the home. The Registered Manager/Provider said the home has not received any complaints. From talking with people they all said they could approach a member of staff or the Registered Manager/Provider if they had any concerns. Out of the five surveys received from both people living at the home and from visitors, three said they know how to make a complaint and two said they did not know how to make a complaint. Four people had responded to the question does the service respond appropriately to complaints; two had said ‘always’ and two said ‘usually’. Since the last inspection the care staff have undertaken the ‘Alerter’s Guide’ training and the Registered Manager/Provider is going to arrange this for the recently appointed staff. Copies of the leaflet ‘Alerter’s Guide’ are available in The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 17 the main entrance of the home. The home has policies for abuse, bullying and harassment and whistle blowing. The Registered Manager/Provider said that as part of their induction programme the staff have to read the policies and procedures folder. No staff have been referred to the POVA list. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is good providing people who live there with an attractive and homely place to live. EVIDENCE: A tour of the environment took place with a number of rooms belonging to people living at the home observed. Rooms belonging to people living there have their own possession displayed and were all very individual. One person living at the home had made a comment in their survey that they ‘would like a little more room for their personal belongings’. The home appears to be well maintained and a very pleasant outside seating area is provided for people when the weather is warm. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 19 A comment received on a survey completed by a visitor to the home said ‘they provide a comfortable and relaxed environment suitable for my relatives needs’. People spoken with all said they are happy with the cleanliness of the home and that the domestic does a very good job and a one person had ticked on their survey that the home is ‘always’ clean and fresh. Staff were seen wearing protective clothing when required. The laundry appeared to be well organised and the procedure for dealing with soiled clothing was discussed. Consideration should be given to the staff wearing protective clothing gloves and apron if they are going to soak soiled clothing prior to washing. People living at the home said they are happy with the way their clothes are looked after. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is confident that the numbers of staff on duty meet the needs of the people living there, however the processes for staff training still need improving to ensure staff receive the appropriate training. The standard of vetting and recruitment practices still need improving to ensure the appropriate checks are being carried out and not potentially leaving service users at risk. EVIDENCE: Five care staff work at the home and two of these has completed their NVQ 2 training. The home also employs two cooks, a domestic and a general assistant. The staffing levels are one care staff on each shift except for nighttime as the Registered Manager/Provider provides cover as she lives on site. The Registered Manager is also available during the day. A comment received on a survey completed by a visitor said ‘ they are not sure if there is sufficient staffing and they don’t know about night-time cover’. Staff spoken with said it is a nice friendly place to work and one member of staff has been working at the home for eleven years. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 21 Comments received about the staff from people living in the home and visitors were all very complimentary. One person said ‘ the staff are very helpful and patient when asked about something’. The personnel files of three staff that have recently started at the home were examined. All had the required checks had been undertaken, except one member of staff had a full employment history but no dates. It was difficult to ascertain when each member of staff actually started work as this was not included within the file and the Registered Manager/Provider was not able to provide the dates. Because of this it was difficult to determine if the Povafirst check had been received prior to the member of staff starting work. All three had their Criminal Records Bureau disclosure returned to the home. Photographs are required for two of these members of staff, otherwise all the required information for their identity has been obtained. The homes procedure for recruitment was not inspected and the home should ensure it is all up to date with the latest legislation. The home has evidence that the three recently appointed staff have completed their induction training as the checklist used by the home was seen. The home needs to ensure that their induction training is in line with the Skills for Care common induction standards and should register with the local contact in this area if they have not done this yet to receive the required information. The Registered Manager/Provider said she supervises new staff. Plans for training for staff was discussed. Food and hygiene training is planned for July 2007, however two members of staff prepare food at the moment but have not done this training and therefore should not be preparing food unless supervised by another member of staff who has done this training. First aid is due later in the year and the home needs to ensure that all staff have an awareness of this as one member of staff said they have not undertaken this training. The Registered Manager/Provider said they are up to date with fire training. Consideration should be given to the home providing infection control training and other training pertinent to the needs of the people living at the home. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Registered Manager/Provider has a supportive, open approach to running the home, which benefits the people living there, staff and relatives. However there are areas that need improvement to meet the standards. There are systems in place to obtain the views of people living at the home. To ensure the people living at the home have their health and welfare promoted and protected, the home needs to undertake assessments of risks in certain areas to ensure the people at the home are safe. EVIDENCE: The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 23 There have been no changes to the management of the home since the last inspection. The Registered Manager/Provider has completed the Registered Managers award. She is a registered nurse and is aware of the importance of keeping herself updated. The Registered Manager/Provider said she undertakes the same training as the staff and had plans for a course in recruitment. Two requirements remain outstanding since the last inspection and in one case the last two inspections and these must be addressed. People living at the home and staff all said the Registered Manager/Provider is approachable and friendly. Meetings for people living at the home take place yearly and people confirmed that they are asked about their menu choices. Minutes of these were meetings were not examined at this inspection. As the Registered Manager/Provider lives on site she is available to see staff when they are on duty and at each shift there is a handover and communication book is available for staff. Therefore staff meetings do not take place. The home sent out questionnaires to people living at the home in May this year and is planning to send them out to relatives. The home will need to collate these results and use them in their development plan for the home. The Registered Manager/Provider said she undertakes monitoring of the home and has started to record these and again The Registered Manager/Provider has reviewed their policies and procedures since the last inspection. The home does not manage any monies for people living at the home. Evidence was seen of staff supervision sessions and staff spoken with confirmed this. Evidence was seen of servicing of equipment and boilers. The home does not have any hoists. The home had a test for Legionella last year and this is due to be repeated shortly. Showerheads are cleaned out monthly. The home said care staff checks the temperature of bath water for people at the home and it is recommended that risk assessments be completed for each person in relation to hot water. Fire checks are undertaken and records were seen of these. The fire equipment is due to be checked by an outside contractor shortly. A fire risk assessment has not as yet been completed as required by the Fire Regulations. The Registered Manager/Provider should contact the fire service for advice about this and their evacuation procedure. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 24 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 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 3 X 2 The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 25 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 OP29 Regulation 19 Requirement All members of staff must be subject to full recruitment procedures. This requirement has been repeated from the last three inspections. The registered person must ensure that all staff receives training appropriate to the work they are to perform. This requirement has been repeated from the last inspection. Timescale for action 30/06/07 2. OP30 18(1)(ci) 18/08/07 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. Refer to Standard OP1 Good Practice Recommendations The home should consider making the changes to their Statement of Purpose/Service Users Guide as described in this standard. The Laurels DS0000016615.V337811.R01.S.doc Version 5.2 Page 26 2. 3. 4. 5. 6. 7. OP1 OP3 OP9 OP9 OP12 OP26 8. OP30 The home should display a copy of their Statement of Purpose/Service Users Guide in the main entrance to the home. The home should date all pre admission assessments when devised. The home needs to devise a protocol for the person who needs medication following a wasp sting. The home should devise care plans for people who take ‘prn’ or ‘as and when required’ medications. The home should review whether they are going to put an activities programme in place for people at the home. If staff are going to soak soiled clothing prior to washing then they should wear gloves and aprons for their protection. Otherwise to reduce risks to the staff the clothing should be put straight into the machine. The home should consider devising a training matrix for easy recognition of what training staff have undertaken and when they are due. The home should contact the local fire Service to obtain advice about their fire risk assessment and evacuation procedure. 9. 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