Inspection on 07/09/05 for The New Close

This inspection was carried out on 7th September 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 New Close 08/08/06

The New Close 17/01/06

The New Close 29/11/04

The New Close 21/04/04

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

CARE HOMES FOR OLDER PEOPLE The New Close Conyngham Lane Bridge Canterbury Kent CT4 5JX Lead Inspector Nicki Dawson Announced 7/09/2005 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 New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The New Close Address Conynham Lane, Bridge, Canterbury, Kent, CT4 5JX 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) 01227 780070 01227 830710 Kent Community Housing Trust Mrs Susan Keiper Care Home 63 Category(ies) of Dementia Over 65 (63) registration, with number of places The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Dementia aged 60 and over Date of last inspection 29 and 30th November 2004 Brief Description of the Service: The New Close is a residential care home providing care for up to 63 people, aged 60 and over, with dementia. The home is situated in a cul-de-sac in the village of Bridge, near Canterbury. The village has a number of shops, including a post office, pharmacy and small supermarket. The New Close is owned by Kent Community Housing Trust, which manages 22 residential care homes for older people in Kent and in addition provides a range of home care services. The New Close is an extended bungalow, providing ground floor accommodation for all residents. Extensive gardens surround the home and there is a large parking area to the front of the property. The home has been divided into two by a coded door entry system, with separate staff teams for each wing. This enables staff to have free access to all areas of the home and limits the access for residents, to ensure their safety. Each wing has a dining room, a number of small lounges and a visitor’s room. Resident’s rooms are accessed from the lounge areas. There are 55 single rooms, of which 23 are en-suite and 4 double rooms. The home contains a large number of toilets and 7 bathrooms with disabled facilities. The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place over two days. About two thirds of this time was spent interviewing ten staff. The inspector also spoke with two relatives, shared lunch with the residents, toured the home, observed the medication round and spent time in the office looking at records and speaking with the manager and deputy manager. The registered manager and the manager of another residential care home, owned by Kent Community Housing Trust, have changed places for a period of six months. Therefore, Jane Ansell is managing the home until February 2006. The inspector received information about the service, from the registered manager and four residents and relatives, prior to the inspection. These residents all agreed that they were well cared for. The majority of relatives stated that there were not always sufficient numbers of staff on duty, but that they were satisfied with the overall care provided by the home. What the service does well: What has improved since the last inspection? What they could do better: The nature of caring for people with dementia, is that their condition deteriorates over time and their needs become greater. The staffing levels of the home have not been adjusted to take this into consideration and as a result, staffing levels continue to be insufficient to meet the complex needs of the residents. Some staff practices in relation to the administration and storage of medication need to be changed in line with good practice guidelines, in order to ensure that residents are not placed at risk. The range of activities provided by the home is good, but limited in terms of the staff hours and the resources available. The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 6 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 New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 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 standard(s) 1 and 4 The home provides a wealth of information to prospective residents. The Service User Guide should be written in a way which is more easily understood by people with dementia. Staff are stretched in order to meet the high level of needs of residents. EVIDENCE: Three pieces of written information about the home are available to prospective residents. The first is the Statement of Purpose, which sets out the aims and objectives of the home and the facilities and services provided. The second is the Service User Guide, which details the terms and conditions of accommodation, staff qualifications and a summary of the complaints procedure. The third is the Kent Community Housing Trust’s Care Homes brochure. A lot of time and effort has been taken into preparing this document, which contains a photograph of the New Close, photographs of interaction between a resident and staff member and a comment from a relative about the home. It also sets out the aims and objectives of the organisation and gives details of all the services provided by the organisation. If this pictorial format, with photographs and comments from relatives and residents was applied to the service users guide, it would give the guide more meaning for the residents, for whom it is intended. The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 9 All staff, including domestic staff, have been trained in working with people with dementia and this good practice is commended. The general manager stated that since the last inspection there has been, “a thorough and comprehensive reassessment of all residents to ensure that the home is capable of meeting all care needs”. Currently there are 54 residents in the home of which 85 need help with toileting; 48 require two or more staff to undertake their care; 27 require help with eating meals and 7 are immobile. Hence, residents have a high level of care needs requiring high levels of staff support. All staff stated that more staff were needed in order to give a good level of care to residents. They felt that basic needs were being met, but often tasks were rushed and that they had no additional quality time to spend with residents. 83 of relatives questioned, stated that staffing resources are stretched and under provided for, but that they were satisfied overall with the level of care provided in the home. The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, and 10 In order for resident’s individual plans of care to be comprehensive working documents, a limited amount of updating is needed. Staff treat residents with dignity and respect. The systems for the administration of medication need strengthening and potentially put residents at risk. The health care needs of some residents need further investigation in order to establish whether they are being fully met. EVIDENCE: Resident’s individual plans of care were sampled and contained a social history, an assessment of daily living needs, including health, mobility, likes and dislikes. These assessed needs are comprehensively developed into a plan of care, with each task being broken down in terms of how much support is needed. Staff said that they refer to care plans on a daily basis; relatives said that they were made available on request; and all plans examined had recently been reviewed. Potential risks in daily living have been identified and a strategy written as to how each potential hazard should be managed. With one exception, all risk assessments had been signed and dated, to indicate to staff the currency of the risk. A detailed moving and handling assessment had been undertaken for each resident. One assessment viewed did not correspond with the actual care given to the resident concerned. The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 11 The health care needs of residents are clearly outlined and developed in the individual’s plan of care. Each resident has a falls assessment and a record is kept of any falls and accidents in their individual plan. On average one resident a month is sustaining a fall resulting in a visit to hospital. Staff explained the importance of fluid intake and differing types of diet on the wellbeing of resident’s health. Team leaders are responsible for arranging health professionals visits, and these are recorded in the resident’s individual plan. 55 of residents are visually impaired, but only a small percentage of staff has received training in this area. Five residents have pressure sores. It would therefore be prudent for the home to examine in detail the plan of care in relation to these residents and to ensure that sufficient is being done in general to address the promotion of tissue viability for all residents. Staff were observed communicating with residents in a courteous and respectful manner and residents who needed health treatment were gently coaxed into a private area. One staff explained that, “dignity is very important in (giving) personal care” to residents. The storage, administration, recording and disposal of medications were inspected and a number of changes are required. One staff was observed administering medication. She carefully explained to each resident was about to happen, and was thorough in ensuring that the right medicine was given to the right resident. The administration of medicines at the home are clearly recorded and staff are aware of the issues surrounding administering medications to people with dementia. Clear procedures are in place and are followed when GP’s prescribe medications over the telephone. However, not all staff are following the correct procedure when medications are dropped, or refused and need to be stored and administered later. The storage room for medicines was examined and although medications were stored correctly, it is in need of reorganisation to ensure that staff can be more effective and so reduce the possibility of medication errors. Returned medicines were stored in a variety of locked cupboards and need to be maintained in one area. Drugs being returned to the pharmacy are recorded in a number of books and this can be confusing. The home’s policy that a small stock of homely remedies may be kept with consent from each resident’s GP was not being adhered to. The fridge for storing medications needed defrosting and the temperature had consistently been recorded as too hot, but staff had not taken any action to rectify this. Of most concern was that one medication was being used for a resident to whom the medication had not been individually prescribed. The room contained a number of non-medical items, including a large box labelled as ‘unidentified false teeth’. Staff were required to remove and dispose of this immediately. There is a first aid box in each wing of the home. However, there was no list to identify it’s content and the content of both boxes varied. Also, the area in the medicine room for storing first aid items was disorganised. The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 12 The New Close H56 H05 S23607 The New Close V239478 07092005 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 and 15 The activities offered are of good quality, but additional hours and resources are needed to address the needs of all residents, particularly those with little communication skills. Staff encourage residents to make choices. The meals are appealing and wholesome, offering both choice and variety and catering for special dietary needs. EVIDENCE: The daily routine of the home although structured, has a certain amount of flexibility. It was observed that at breakfast time, residents come to the dining area individually, and were not rushed. Currently, there is one activities organiser at the home on a Monday to Friday. During the inspection residents were observed in small groups participating in quizzes, singing, reminiscence therapy and taking lunch in the garden. Individual foot spas also took place, and entertainers are booked to visit the home. These activities are highly commendable, but the activities person does not have sufficient time to engage all of the residents, plus, two day care clients. The residents with high needs and little or no communication are often not involved and the reestablishment of the sensory room would do a lot to towards meeting their needs. It was observed that most of the residents in one wing of the home spend most of the morning asleep. Staff confirmed this. The views of residents were that there are suitable activities available at the home. However, a relative commented that “Not much activities go on and some residents don’t get out at all….. (not even) in the garden”. Residents, who wish, are able to The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 14 attend communion on a monthly basis. Relatives are fee to visit the home at any reasonable time and may see their relative in private. One staff explained honestly that staff “try to give residents choices, but it is not always easy”. Staff were observed encouraging residents to make choices. For example, one care staff showed a resident two bowls of breakfast cereal and asked her to indicate which one she preferred. The inspector joined residents for lunch on both days of the inspection. The food was well presented and residents were clearly enjoying their meals. Residents, who need support to eat, were assisted in a dignified manner and there was a relaxed atmosphere. The menu for the week is displayed outside the kitchen and residents are consulted about the choice of food. The cook has recorded the special dietary needs and allergies of all of the residents. She runs a very organised kitchen and takes pride in her work. The New Close H56 H05 S23607 The New Close V239478 07092005 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) EVIDENCE: The New Close H56 H05 S23607 The New Close V239478 07092005 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 and 25 The New Close provides a safe and comfortable environment for residents. Resident’s enjoyment of the home would be further promoted by an assessment by an occupational therapist of the disabled facilities provided by home. EVIDENCE: The New Close is an extended, detached bungalow, set in large grounds, next to a primary school, in a cul-de-sac in the village of Bridge. The home is divided into two by a coded entry door, separating the home into two wings of thirty residents. This enables staff to supervise residents more easily. Each wing has a dining/lounge area and one or two additional lounge areas, and a visitor’s room. Resident’s rooms are accessible from the lounge areas and are located in groups of ten. After undertaking an assessment to promote resident’s safety, resident’s bedroom doors are locked during the day. The home has extensive gardens, including a small, enclosed garden, which is accessible from one wing of the home. Some residents were enjoying the garden on the day of the inspection, but relatives commented that not all residents are given this opportunity. The day of the inspection was very hot The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 17 and fans were being used in communal areas to make the temperature more pleasing. Selected bedrooms viewed were decorated according to individual needs and tastes. The manager said that the home has a rolling maintenance programme and is in the process of replacing vinyl flooring in resident’s rooms with carpet or non-slip flooring. New bedroom furniture was being delivered and fitted during the inspection. Furniture and fittings were of good standard. The home benefits from sixteen toilets, seven bathrooms with disabled facilities and a shower room. Due to the number of residents at the home with mobility problems, the home would benefit from an assessment by an occupational therapist. The New Close H56 H05 S23607 The New Close V239478 07092005 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 and 30 The care staff team are not available in sufficient numbers to meet the high levels of residents need. A robust recruitment procedure is in place to protect residents. Staff training is important in this home and could be developed in further areas to enable staff to understand the complex needs of the residents. EVIDENCE: A home manager and deputy manager manage the home. They receive parttime administrative support. The names of staff on duty each day are written on a notice board and relatives said that this was helpful. Care staffing levels are as follows for each wing of the home:- 7am to 2pm there is 1 team leader and 4 care staff; 2pm to 9 pm there is 1 team leader and 3 care staff. Then from 9pm until 7am there is 1 team leader and 3 care staff for the whole of the home. It was noted earlier that 48 of residents need 2 or more staff to undertake their care needs. Staff said that they feel rushed when undertaking personal care tasks and have little quality time to spend with residents. Comments from relatives and information from residents care plans indicate that staff are particularly busy during the time when residents rise and retire. This can result in residents being unattended in communal areas for long periods of time. Staff demonstrated throughout the inspection that they were motivated and wanted to give a high level of care to the residents, but were frustrated in doing so through lack of time. An urgent review of staffing levels is needed to ensure that residents’ needs are met, especially at peak times of the day. Staff were observed laughing with residents, singing with them and gently coaxing them, saying “take your time”. One staff said that trying a “different approach” or “trying again later” was an important part of their job. The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 19 Staff mostly said that communication was effective in the staff team. Communication is achieved by the communications book, staff handovers between shifts, and team leader and staff meetings. Domestic staff said “feel part of the same team” There is one cook/assistant cook and one kitchen assistant on duty during the day. There is one laundry person and 5 domestic staff on duty from 8am until 2pm. A maintenance person is also employed. One agency is used to cover any vacant shifts. Staff said that new agency staff need a lot of directing, but that if they have been to the home on a number of occasions, they are an asset to the team. All care staff undertake induction training to National Training Organisation standard, as required by the National Minimum Standards. In-house induction training complements this. 45 of staff have been trained to NVQ Level 2 and therefore the home is making excellent progress to achieving the National Minimum Standard that 50 of staff are trained to this level by December 2005. There is a written training plan for the whole staff team with a list of training that is due to be undertaken. All staff are trained in dementia and additional staff have undertaken training in challenging behaviour. Throughout the inspection, staff demonstrated that they had a good understanding of the needs of people with dementia. It was noted at the last inspection that additional staff require training in loss and bereavement and highlighted previously in this report that training in visual awareness would also be beneficial. An examination of personnel files showed that before an employee commences work at the home, a thorough recruitment and selection procedure is undertaken, including the necessary pre-employment checks. The New Close H56 H05 S23607 The New Close V239478 07092005 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) 31, 36 and 38 The manager is qualified, competent and experienced to run the home. The frequency of staff supervision needs to be increased to ensure that staff are well supported. The health, welfare and safety of residents and staff is promoted. EVIDENCE: Sue Keiper, the registered manager of this home has changed places for 6 months with Jane Ansell, the registered manager of another residential home owned by the Kent Community Housing Trust. Jane Ansell has worked with the elderly for 16 years, and managed a home providing care for people with dementia for 3 years. She has completed NVQ level 4 in Care and Management as required by the National Minimum Standards. She has managed the home for 1 month and therefore it is too early to comment on her management approach of the home. However, staff said that she spend a lot of time with the residents and that she was approachable. The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 21 Staff files viewed showed that there is a structured format for supervision, but that it only occurs two or at most four times in a year. Staff seemed unsure of the frequency that was required. The National Minimum Standards state that staff should be supervised six times a year. Staff said that team leaders were approachable at other times. An inspection of records revealed that maintenance of gas appliances, electrical installation and portable equipment, and fire fighting equipment had been undertaken. Fire drills and training are carried out on a regular basis. Environmental risk assessments have been undertaken and the maintenance person said that in addition a visual check of the premises is carried out each day to ensure the safety of residents. Domestic and care staff are trained in health and safety and care staff receive other statutory training. Domestic staff were knowledgeable about the handling of harmful substances that they may use in their work. The New Close H56 H05 S23607 The New Close V239478 07092005 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 3 x x 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 x x x x 2 x 3 The New Close H56 H05 S23607 The New Close V239478 07092005 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 OP7 Regulation 15 Requirement Timescale for action 30/12/05 2. OP8 17 3. OP8 12 (1) a 18 (1) a 4. OP9 13 (2) The registered person must ensure that in the individual plan of care for one resident, the risk assessment is signed and dated and that the moving and handling assessment is updated 30/12/05 The registered person must make an examination into the treatment of those residents with pressure sores and ensure that sufficient is being done to promote the tissue viability of all residents, seeking further professional advise as necessary. Then send a copy of the findings to the Commission for Social Care Inspection The registered person must ongoing continue to monitor the level of falls within the home, giving consideration to the levels of staff and skills mix and an analysis of interventions for residents at risk of falling The registered person must immediate ensure that:medication is only administered to the person to whom it is prescribed; staff follow the correct procedure when:Version 1.40 Page 24 The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc 5. OP9 13 (2) medication is dropped in administration; medication is refused at the first instance and administered shortly thereafter The registered person must ensure that:a safe system is in place for the storage and recording of returned drugs; staff follow the homes policy in relation to administration of homely remedies; that the drug fridge is kept in good working order and appropriate action taken when this is found not to be the case; there is a list for each first aid box and the contents are restocked as needed The Registered person must ensure that the premises are assessed by a suitably qualified occupational therapist affirming evidence of suitable adaptations and equipment The registered person must undertake a detailed review of the staffing levels to ensure that at all time staff are in sufficient numbers to meet the health and welfare needs of residents 21/10/05 6. OP22 23 1/4/05 revised to 30/2/05 7. OP27 and OP4 18 1 (a) 30/12/05 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 OP1 OP8 and OP30 Good Practice Recommendations The registered person should give consideration to presenting the service users guide in a format that has meaning for residents for whom it is intended. The registered person should ensure that staff training in visual impairment sis extended to include more staff. H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 25 The New Close 3. OP12 4. 5. 6. OP30 OP36 The registered person should ensure that all residents have the opportunity to engage in social activities. In order to achieve this, they should give consideration to reestablishing the sensory room and deploying additional activity hours. The registered person should ensure that staff training in loss and bereavement skills is extended to include more staff The registered person should ensure that staff receive supervision 6 times a year. The New Close H56 H05 S23607 The New Close V239478 07092005 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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 New Close H56 H05 S23607 The New Close V239478 07092005 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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