Inspection on 22/08/05 for The Limes Rest Homes

This inspection was carried out on 22nd August 2005.

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

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

Other inspections for this house

The Limes Rest Homes 25/09/08

The Limes Rest Homes 14/07/06

The Limes Rest Homes 28/12/05

The Limes Rest Homes 20/01/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Limes Rest Home 75-79 Cartland Road Stirchley Birmingham B30 2SD Lead Inspector Kulwant Ghuman Unannounced 22 August 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Limes Rest Home Address 75-79 Cartland Road Stirchley Birmingham B30 2SD 0121 443 1789 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) First Care Services Ltd Miss Eileen Isobell Murphy Care Home 28 Category(ies) of Older People, Dementia 65 [28] registration, with number of places The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the registration category is 28 older people with dementia (OP). 2. That a washing machine with a sluice cycle is made available in the home within 12 months or when one of the existing machines needs replacing, which ever is earlier. 3. That a commode pot washer/disinfector is installed at the same time as the sluice cycle washing machine. 4. Ramped access to the patio area is provided from the lounge and dining room by April 2005. 5. The patio area near the laundry needs to be risk assessed and made safer for service users by April 2005. 6. All service users will be supplied with lockable piece of furniture within six months of change of registration. 7. The fluorescent strip lighting in the corridors to be replaced with lighting more domestic in style by August 2005. 8. Orientation signage appropriate to the needs of the service users to be in place by March 2005. 9. An additional socket and light switch to be provided in room 23 by 31st November 2004. 10. All service users to be provided with furniture as detailed in the National Minimum Standards for Older People by June 2005. 11. The home must adhere to a laundry policy which ensures that soiled laundry is not transported through the dining area when meals are served or consumed. 12. All radiators to be risk assessed and guarded or replaced with LST radiators where guarding is not appropriate by 1st December 2004. 13. That Eileen Murphy successfully undertakes the Registered Managers Award or equivalent by April 2005. 14. The home can provide care for two named people under 65 years of age for reasons of dementia and 1 named person under 65 years for reasons of physical disability. Date of last inspection 20 January 2005 The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 5 Brief Description of the Service: The Limes is a care home providing personal care and accommodation for 28 people who are elderly and physically dependent due to old age. It is a private home owned by First Care Services Ltd. The home is situated in Cartland Road, Stirchley, Birmingham and is close to local amenities. The Limes is situated on a busy bus route but it is set behind a small front garden. It consists of three two-storey adjoining houses that have gradually been incorporated over the years. There are several lounges including one for smoking, a separate dining room and an attractive rear garden with patio, lawn and flower beds which provides an additional facility for service users to enjoy during the summer months. There is a large car park to the rear of the building. There are twenty single and four twin-bedded rooms. Some bedrooms have en-suite facilities and there are assisted bathing facilities in the home. There is a passenger lift and a stair lift. On the ground floor there is the kitchen where meals are prepared and a laundry. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced visit over one day during August 2005. This was the first of the statutory inspections for the home for 2005/2006. During the inspection the inspector observed activities in the lounge areas during the breakfast period, toured the building, sampled some documents and spoke with 3 residents. The overall impression of the home was that it was well organised, calm and welcoming of visitors. The residents appeared to be well cared for. What the service does well: What has improved since the last inspection? There has been a significant investment in the home during the past year including the re-development of the garden, ramped access into the garden, replacement of some bedroom furniture and carpets. There is an ongoing plan for redecoration in the home and repairs have been carried out to the flat roof above one of the lounges. The entrance area has been redeveloped to make it more suitable for residents who wish to sit in this area. Some of the fluorescent lighting has been replaced with more domestic lighting. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 7 A large extractor hood has been fitted in the main kitchen to manage the kitchen temperatures. The home is monitoring the occurrence of unexplained injuries in the home to identify any patterns or training needs for staff. 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. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, 5 Information for prospective residents was not adequate to ensure they had all information needed to make an informed choice. Residents were always assessed by the home prior to being admitted to the home to ensure that their needs could be met but the home could further ensure this if they had access to all the available information about the resident by obtaining the assessments carried out by the referring professionals. EVIDENCE: There was a statement of purpose and service user guide in place at the home at the previous inspection. These documents were being updated and amended to ensure that the language used in them was easy to understand for residents. Some suggestions were made by the inspector regarding the information to be included. Three service user files were sampled and all had a copy of the terms and conditions of residence on them. The home had been out to assess all the service users before admitting them to the home but there was no copy of the assessment of need carried out by the referring professional on all the files. The registered manager needed to The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 10 ensure that either a copy of the assessment carried out by referring professionals was received prior to admitting the resident or, where no such assessment was in place, the home must carry out its own comprehensive assessment before admitting the resident. Two of the residents did not have a pre-admission visit to the home as it was felt to be too traumatic for them, for the third resident there was evidence in the diary that there had been a visit to the home but there was no recorded evidence that any assessment was carried out during that visit. The registered manager needed to ensure that a record of the assessment carried out at the pre-admission visit was made and on which the decision to admit the individual was based. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9, 10 There was lots of information available on the files regarding residents’ needs but some work was still needed on the care plans to ensure that care needs were clearly stated. The health care needs of residents were being met by the home. The management of medicines in the home was generally good and residents were treated with respect and dignity. EVIDENCE: The home had introduced a daily living summary that gave some very good information in one of the files sampled on how the needs of the individual were to be met by the care staff. There was lots of information available in the assessments carried out by the home indicating risks such as nutrition, tissue viability and falls. The registered manager needed to ensure that where a risk had been identified, for example, risk of aspiration, when a resident needed to be placed on the floor when experiencing a fit or when a resident was being aggressive that there was a corresponding strategy for staff to follow. The registered manager needed to ensure that there was a care plan in place for all residents that care staff could turn to and quickly access the relevant information. It was evidenced during the inspection that all the information was available but it was difficult to access the information. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 12 Staff were writing up a monthly evaluation that was then checked by the manager. Any changes to needs must be updated on the care plans and the registered manager must ensure that there is a 28 day review for all residents to ensure that the home is able to meet the residents needs and the resident is happy with the services provided. The daily records completed by the care staff tended to be very repetitive usually saying that the individual ate and drank well and that medicines had been given. The daily records needed to give an overview of the day for that individual indicating any activities undertaken or refused. The health care needs of the residents were being met appropriately by the involvement of district nurses, chiropodists, opticians, dentists and the local hospitals for specific needs. Pressure relieving equipment was in use where required. The management of medicines in the home was generally very good. During an audit of the system it was noted that staff did not always record the amounts carried over from one month to the next, and there were instances where medicines had been given but not signed for and in one case the eye drops had not been dated on opening. During a tour of the building it was noted that a tub of Sudocream was left in the bedroom although the resident was not self administering, the outside of the tub was covered with cream. Staff should not leave medicines in bedrooms except in lockable drawers to prevent service users with dementia misusing them. The residents advised that staff did not enter their bedrooms without knocking on the doors. Some residents locked their bedroom doors. There were the appropriate locks on doors throughout the home. There were privacy screens in shared bedrooms and glass panels in bedroom doors had been covered. There was no shower curtain in the ground floor shower and several hooks were broken in the shower on the first floor. Good interactions were observed between the residents and staff. One of the residents preferred a male carer to assist them with bathing and showering. Attempts were made to ensure that this preference was complied with as far as possible. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15 There were no rigid rules or routines in the home and residents could spend their time as they chose. There were some organised activities for those residents who wished to take part. The residents were satisfied with the catering arrangements at the home. EVIDENCE: At the time of the inspector’s arrival (8am) there were 13 residents sitting in the lounge areas. One of the residents told the inspector that residents had their breakfast as they came down. It was observed that some residents were having breakfast in the dining room, one resident took her breakfast back to her room and another resident had breakfast in the lounge. Choices of cereal were seen to be available to the residents. Throughout the day it was observed that residents were free to wander around the home going back to their bedrooms when they wanted. Some residents spent the whole day in their bedrooms. The bedroom doors were alarmed so that if someone went into a bedroom when the resident was in the lounge the staff would be alerted to the fact. Staff said that this was needed as some of the residents wandered into other residents’ bedrooms. Visitors were seen to be in the home for various amounts of time and some were seen to have a meal with their relative. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 14 There were visits from the local churches and church services were held in the home. There were set menus which are followed. These did not identify a second choice of meal available for the residents to choose from but the staff were aware of residents likes and dislikes. There was documented evidence that on some occasions a different meal was provided to one or two residents. The possibility of providing a second choice for the main meal was discussed with the kitchen staff and owner, as preferences could change on a day-to-day basis and residents were made aware and reminded regularly of what the alternative meal available was. Residents spoken with were happy with the food available both in respect of quality and quality. Diabetic diets were catered for and two residents required dietary supplements. It was advised that a system was set up that ensured that the required supplements were being added by the staff as it was not clear that this was being done on a regular basis due to the excessive amounts of supplement remaining in the cupboards. There were some organised activities in the home. Some of the residents had recently been on a day trip out that was enjoyed by all. Two of the residents received daily newspapers and were seen reading these. One of the residents was involved in the washing up after drinks. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection EVIDENCE: The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25, 26 Recent investment has significantly improved the appearance of this home creating a comfortable and safe environment for those living there. Residents are able to exercise choice in where they spend their time as all areas of the home and garden are accessible to them. EVIDENCE: The home was found to be homely and comfortable and several areas of the home had been redecorated. The entrance hall had been opened up and made more comfortable for residents to sit in. At the time of the inspection one of the lounges was out of use as it had been redecorated following a leak in the ceiling. The flooring was being levelled before new carpets were laid. The residents had access to sufficient communal space to meet their needs. Work had been carried out on the garden area and there was now ramped access into the garden and the garden had been levelled to make it more accessible to the residents. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 17 There were adequate numbers of bathing and toilet facilities throughout the home. All had been fitted with appropriate privacy locks. There was a passenger lift and stair lift available in the home. At the time of the inspection the internal doors to the lift were not closing. By the time the inspector was leaving the company had arrived to address the issue. There were other adaptations available in the home including a call system, two mobile hoists, assisted bathing facilities and grab rails in toilets. The registered person needed to ensure that all call points were accessible in bathrooms and bedrooms. Residents’ bedrooms were found to be homely and comfortable. The owners had replaced several beds, bed linen and some carpets. The bedrooms had been made comfortable and personalised to the residents liking. Some of the bedrooms did not include all the required furniture and secondary lighting but there was an ongoing programme of replacing furniture that was no longer suitable. The home was centrally heated with a hot water supply to all rooms. Hot water temperatures were found to be appropriately regulated. Fluorescent lighting on the ground floor had been replaced. Some diffusers were found to be missing from lights in corridors on the first floor. Care staff and kitchen staff were wearing the appropriate protective clothing. There were adequate laundry facilities available. The issue of cleanliness in the home was raised in the home as it was noted that some commode pots had not been adequately cleaned and a commode pot had been left in the assisted shower. The registered manager needed to ensure that all meats are dated on freezing and find an alternative method if the labels keep falling off. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 Staffing levels and competencies were such that the needs of the residents could be safely met. The recruitment procedures needed to ensure that they were robust in all cases to ensure that residents are supported and protected. EVIDENCE: Examination of the rotas showed that there were 4 care staff on duty during the day in addition to the manager or deputy manager. In addition to the care staff there were dedicated catering, cleaning and laundry staff on duty each day. There was a mix of genders in the staff group reflecting the resident group. There was also a mix of different age groups in the staff team. One of the residents told the inspector that there were quite a few new members of staff who seemed to be very good but there were also a number of staff that had worked at the home for a long time providing continuity of care for the residents. The inspector observed good interactions between staff and residents and although the documents did not always clearly identify the strategies to be used staff showed a good understanding of the needs of the residents at the home. Two staff files were sampled on this occasion. One of the files did not have the page relating to employment history available for inspection and did not have a copy of the work permit or visa on file to The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 19 show the individuals eligibility to work. One of the files did not evidence that an induction programme had been carried out. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 37, 38 The home is operated in the best interests of residents and the manager ensured the smooth running of the home in a competent manner. The health and safety of the residents and staff was very well managed. EVIDENCE: There appeared to be an open and inclusive atmosphere in the home. Senior staff were aware of the issues in the home and had taken on responsibilities according to their experience and skills. The home was managed so as to meet the needs of the residents as evidenced by the breakfasts being given as individuals were ready rather than having to wait until every one was up and ready, some individuals went out with relatives and some undertook some household tasks and visitors were welcome to visit and have a meal with the residents. The management of documents within the home was good although some development was required to the care plans and recruitment records. The The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 21 home was monitoring injuries or accidents that were identified by staff to determine if specific residents or staff were involved. As a further development the home needed to audit where these injuries were being noted to see if any work practices could be identified as a possible cause. The registered person needed to ensure that the accident records included sufficient detail to show what had happened, which residents were involved and a description of the injuries that identified exactly where they were. Health and safety in the home was well managed however, it was noted during the inspection that at least one resident was being moved around the home without two foot plates in use on the wheelchair. The storage of wheelchairs also needed to be better managed as the wheelchairs were restricting the access to one of the bedrooms. Infection control and cleanliness needed to be supervised to ensure that commode pots were adequately cleaned. In one of the bedrooms there was a hole in the wall behind one of the bedrooms that would allow a draft to the head of the resident when in bed. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 2 3 2 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 2 3 3 2 2 STAFFING Standard No Score 27 3 28 3 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x 3 3 x x x 2 2 The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP1 Regulation 4(1) Requirement The registered person must ensure that the statement of purpose and service user guide are in a format and language that is suitable for the residents. (Previous timescale of 1.4.05 not met.) The registered manager must ensure that residents have been assessed by a suitably qualified or trained person and the home obtains a copy of the assessment before admitting the resident. The registered manager must ensure that a record of the preadmission visit and any assessment carried out of a resident is recorded. The registered manager needed to ensure that there was a care plan in place for all residents that care staff could turn to and quickly access the relevant information. The registered person must ensure that service user risk assessment indicate all risks and strategies for managing them. (Previous timescale of 1.4.05 not met.) The registered person must Timescale for action 1.11.05 2. OP3 14(1)(a)& (b) 1.10.05 3. OP5 12(1)(a) 1.10.05 4. OP7 15(1) 1.11.05 5. OP7 13(1)(c) 1.11.05 6. OP7 14(2)(a) 1.11.05 Page 24 The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 7. 8. OP9 OP9 13(2) 13(2) 9. OP9 13(2) 10. OP9 13(2) 11. 12. 13. 14. OP10 OP15 OP15 OP16 12(4)(a) 17(2) Sch4(13) 16(2)(i) 22(1) 15. OP16 22(2) 16. OP22 23(2)(n) ensure that all residents have a 28 day review. The registered manager must ensure that eye drops are dated on opening. The registered manager must ensure that tablets carried over from one month to the next are recorded on the MAR charts. The registered manager must ensure that creams are not left in residents bedrooms unless in a locked cupboard. The registered person must ensure that audits are carried out on the medication system to identify where problems are arising. (Previous timescale of 1.3.05 not met.) Adequate curtains must be in place in the showers. Choices must be introduced into the menus at lunchtimes. The registered manager must ensure that supplements are given as required. The registered person must ensure that the complaints procedure makes clear that a complaint can be referred to the CSCI at any point in the procedure. (Not checked for compliance at this inspection. Previous timescale given 1.3.05.) The registered person must ensure that the complaints procedures is suitable for the needs of the service users and their representatives. (Not checked for compliance at this inspection. Previous timescale given 1.3.05.) The registered manager must ensure that all call points are accessible to staff and residents in the case of an emergency. 1.10.05 1.10.05 1.10.05 1.10.05 1.10.05 1.11.05 1.10.05 1.11.05 1.11.05 1.11.05 The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 25 17. OP25 23(2)(p) 18. 19. 20. 21. 22. 23. OP26 OP26 OP29 OP31 OP37 OP38 13(3) 13(3) 19(1) 9(2) 17(2) Sch4(12) (a) 13(4)(c) The registered manager must ensure that the fluorescent lights have diffusers fitted. Previous timescale of 1.10.04 not met) The registered manager must ensure that the food in the freezers is dated. The registered manager must ensure that commode pots are adequately cleaned. The registered manager must ensure that the recruitment procedure is robust in all cases. The registered manager must ensure that she completes the Registered Managers Award. The registered manager must ensure that adequate details are including in the accident records. The registered manager must ensure that wheelchairs are not used without foot plates and that they are stored safely. 1.11.05 1.11.05 1.10.05 1.10.05 Dec 2005 1.11.05 1.10.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP7 OP38 Good Practice Recommendations Staff should be encouraged to ensure that the daily records for residents gives an overview of the day for that resident. Accident records should be audited regarding the positions of unexplained bruising. The Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Birmingham & Solihull Local Office 1st Floor, Ladywood House 45-46 Stephenson Street Birmingham, B2 4UZ 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 Limes Rest Home E54 S62017 The Limes Rest Home V245954 220805 Stage 4.doc Version 1.40 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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