Inspection on 02/07/07 for The Old Rectory

This inspection was carried out on 2nd July 2007.

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 Old Rectory 16/06/08

The Old Rectory 03/05/06

The Old Rectory 31/10/05

The Old Rectory 30/06/05

The Old Rectory 12/01/05

The Old Rectory 07/09/04

The Old Rectory 12/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Old Rectory, The The Old Rectory Care Home 70 Risley Lane Breaston Derby DE72 3AU Lead Inspector Janet Morrow Key Unannounced Inspection 2nd July 2007 11:00 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 Old Rectory, The DS0000033891.V340167.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. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Rectory, The Address The Old Rectory Care Home 70 Risley Lane Breaston Derby DE72 3AU 01332 874342 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) asheathuk@yahoo.co.uk Mr Allen William Heath Vacant Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2006 Brief Description of the Service: The Old Rectory is a detached property situated in the village of Breaston. It is situated 300/400 yards from the village centre and from a main bus route. The Home is registered to provide care for 26 older people within single rooms and double rooms on the ground and first floors. The first floor rooms can be accessed by both a shaft lift and stair lift. The home has five small lounge areas that can be used fro a variety of different purposes; one is used as a hairdressing room. The home operates a no smoking policy. Information provided in 2007 stated that the scale of fees was £320 - £360 per week. Previous inspection reports were available on request from the provider. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and took place over two days for a total of 7.25 hours. Care records and staff records were examined. Three members of staff, eight residents, two visiting professionals and the provider were spoken with. One visiting professional and one relative were contacted by telephone following the inspection visit. A partial tour of the building was undertaken. Written information in the form of an annual quality assurance assessment was provided by the home prior to the inspection and informed the inspection process. One complaint and one adult protection issue received at the office of the Commission for Social Care Inspection since the last key inspection in May 2006 were discussed during the inspection visit. What the service does well: What has improved since the last inspection? Better information and assessment documentation on preventing falls had been obtained and was being used to identify those residents at risk of falling. The exterior of the home had been painted and two toilets and two showers had been redecorated and renovated. A new format for care planning documentation had been introduced. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 6 What they could do better: The provider must respond in a timely fashion to requirements and good practice recommendations issued by the Commission for Social Care Inspection. Failure to do so has the potential to put residents at risk of harm and could lead to legal action being taken. For example, there was still recruitment information missing from staff files despite previous requirements being issued to ensure that this was in place. Staff recruitment procedures are in urgent need of improvement to ensure that residents are fully protected. Criminal Record Bureau (CRB) checks, Protection of Vulnerable Adults (POVA) checks, fully completed application forms, two written references and identity information must be in place before staff commence working in the home. Responses to complaints must be recorded and show how any concerns have been addressed and whether or not the complainant was satisfied with the outcome. Staff induction and training needs to improve to ensure that staff are fully aware of their responsibilities and are competent in their roles. Quality assurance processes were not developed and there was no clear plan on how the service was going to improve. This must be addressed as a matter of priority to ensure that the service continues to meet residents’ needs and takes their concerns into account. Odour must be addressed in specified areas in the home, (mostly individual bedrooms) and the furniture in specified bedrooms must be refurbished or replaced. Care records must contain an assessment for tissue viability and nutrition to ensure that no care needs are missed. A wider range of activities and entertainment would enhance residents’ quality of life. Repetition in the menus should be avoided. Those residents requiring special diets should have a wider range of desserts and different cultural options would enhance the variety on offer. Old Rectory, The DS0000033891.V340167.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. Old Rectory, The DS0000033891.V340167.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 Old Rectory, The DS0000033891.V340167.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): 3 and 4. Standard 6 did not apply, as the home did not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was sufficient admission information available to ensure that residents’ care needs could be met. EVIDENCE: Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 10 Three residents’ care files were examined and all had an assessment in place that gave sufficient information to establish that needs could be met. Where appropriate, information from the assessment and care management process was in place. The home’s own assessment document contained all the components recommended by Standard 3. However, there was some conflicting information on one file; an assessment stated that a resident needed continence equipment day and night but discussion with the deputy manager showed that this was incorrect. Two visiting professionals spoken with confirmed that the home was able to meet identified needs and one relative stated that there had been ‘no concerns’ regarding the care of residents. Old Rectory, The DS0000033891.V340167.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health care needs were generally met but additional use of risk assessment tools would enhance the care provided. EVIDENCE: Three residents’ care files were examined and care planning was discussed with the deputy manager. All had care plans in place and these were reviewed on a monthly basis. However, there were no nutritional or tissue viability risk assessments in place although some of these areas were addressed in the care plan document. For example, the eating and drinking section of one care plan detailed one resident’s dietary needs. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 12 There were risk assessments in place for risk of falling and for the use of hip protectors plus information on how to deal with the risk on all three files. This information had been compiled and advice sought after several residents had had falls and the Local Authority had become involved under safeguarding adults procedures. Although there was a section in the care plan for most areas of need, there was limited information in some areas; for example, social history information and individual preferences was minimal on all three files. Visits from a range of professionals such as chiropodists, General Practitioners and opticians were recorded. Two visiting professionals spoken with stated that there were no issues with how the home dealt with risk of pressure sores, nutrition or continence and that advice was sought appropriately. A random check of medication administration record (MAR) charts showed that these were signed accurately and codes were used and explained if a medicine had not been given. However, two people were not signing and dating handwritten MAR charts. This is necessary to minimise risk of errors. Three residents’ MAR charts were then examined in more detail and showed that these were signed accurately and that the chart corresponded with the medication given. Photographs were in place for most residents to aid identification. The provider stated that there were no controlled drugs in stock but was aware of the necessity to store these securely. The home did not have a medication refrigerator but was storing several items, such as eye drops, in the main refrigerator in the kitchen. Eye drops were not being labelled with the date of opening. This is important as these items can have a twenty-eight day shelf life once opened. Residents spoken with said they were well looked after and one stated that staff were ‘absolutely marvellous’ and that they ‘couldn’t wish for better people to look after you’. General observation during the inspection visit confirmed that staff and residents had warm relationships and this was acknowledged by visiting professionals who stated that they had no concerns regarding residents’ treatment. However, it was observed that staff did not always knock on bedroom doors before entering. Greater attention must be paid to this to ensure that residents’ privacy is respected. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Meals and activities did not always fully cater for individual needs and preferences and some improvement in this area would enhance the quality of residents’ daily lives. EVIDENCE: Visiting times were open and residents spoken with stated that their relatives could visit at any time. Those relatives spoken with by phone confirmed this, stating that they could visit when they chose. Residents spoken with also stated that they enjoyed visits out with their relatives and the Christmas meal at the local pub. Some activities were organised such as bingo, dominoes, quizzes and card games. However, these occurred on an ad hoc basis when staff had sufficient Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 14 time. One resident spoke with stated they were ‘bored’ and most stated that they would like more opportunity to go out of the home, particularly during summer. Musical entertainers were popular with the residents spoken with, although they stated that these did not occur very often. It was observed that residents had their own routines and chose whether or not to stay in their rooms. Some residents had their own hobbies, such as knitting and reading and were participating in these during the inspection visit. One resident was pleased that they had been able to continue their interest in gardening since being in the home. The provider stated that no one in the home had an advocate at the present time but he was aware of whom to contact to obtain one if necessary. The serving of the lunchtime meal was observed and residents spoken with stated that they enjoyed their food. The meal served was plentiful and nutritious. The menus were examined and showed a rotating menu over four weeks; however, there was a lot of repetition with mince always being served on a particular day and quiche on another. Specialist diets were catered for although there was limited choice for dessert for those residents needing a diabetic diet and there were no options available that reflected cultural choices. Although staff had undertaken food hygiene training, no one had had any training in nutrition. The kitchen was clean and tidy and food stocks were satisfactory. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Adult protection procedures were in place that ensured residents were safeguarded but complaints were not handled thoroughly and had the potential for concerns to be ignored. EVIDENCE: The home had a clear complaints procedure on display that stated complaints would be dealt with in twenty-eight days. Residents spoken with knew who to approach if they had any concerns and were confident of a courteous response. The written information supplied by the home stated that two complaints had been received and had been dealt with in twenty-eight days. However, there was no written record of what had occurred in response to either complaint. One complaint referred to the provider from the Commission for Social Care Inspection had not been properly addressed. There was no written record of the findings although the provider stated that this had been discussed verbally with the complainant. The details of the complaint regarding staff recruitment and staff induction training were upheld following further enquiries during the Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 16 inspection visit. This meant that the complaint had not been fully addressed and there were no records to verify that any discussion had taken place at the time. There had been one adult protection incident concerning several residents that had involved the Local Authority Social Services Department since the last inspection visit in May 2006. The provider had responded appropriately to this and was aware of his responsibilities in reporting any allegations. Staff spoken with were also aware of their responsibilities. There was an adult protection policy in place and the home had a copy of the up to date Derby and Derbyshire Local Authority Social Services procedures. Staff training in adult protection had occurred although this was in need of updating. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 17 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was generally clean and tidy and reasonably maintained but improvements in specified areas need to be undertaken to ensure that residents’ accommodation is comfortable and safe. EVIDENCE: The home was clean and tidy and generally well maintained and the written information supplied by the home stated that some refurbishment had been undertaken, including the decoration of two communal toilets, the exterior of the home and the renovation of two showers. However, there were noticeable areas where improvements were needed: Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 18 • • The stair carpet was worn and in need of replacement. This has been noted in every report since January 2005. Some furniture in bedrooms was in a poor state of repair, such as wardrobe and vanity unit doors not closing properly and not being aligned properly. This has been noted in every report since January 2005. There was an odour in some bedrooms. This was also commented on by visiting professionals spoken with. A number of doors and wooden chairs were badly scratched. • • The laundry was viewed and had one washing machine and one drier that were in working order. The laundry room was cramped and staff were observed folding clothing in communal areas. One resident spoken with stated that they had lost several items of clothing that had not been found during the time they had been at the home. A better system of handling laundry should be considered to manage this problem. Staff spoken with were aware of how to control infection and stated that they had received training in infection control. The provider stated that there was a plentiful supply of protective equipment, such as gloves and aprons, but was unable to show these at the time of the visit. Visiting professionals commented that there was often a lack of provision such as soap and towels in communal toilets. This was also confirmed during the inspection visit; one toilet was viewed that had no soap and the towel available was used communally. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recruitment procedures and staff training and induction were insufficient to ensure that residents were in competent hands. EVIDENCE: The rota for 2nd – 9th July 2007 was seen and showed that there were three care staff on each morning and two in the afternoon. There was also one cook each day and one domestic. This was the case on the day of the inspection visit. The provider stated that due to an increase in residents’ needs, he was to start having two waking staff on at night. Those staff spoken with confirmed this information. Although there were sufficient staff to cater for residents’ needs, staff commented that it was sometimes difficult to fit in all the tasks that were needed, such as laundry and assisting people to move when two members of staff were required. The provider stated that nine of twelve care staff had achieved a National Vocational Qualification (NVQ) at level 2 or above, which meant the home had reached the target of having 50 of care staff with an NVQ2 qualification. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 20 Staff training took place in mandatory health and safety courses but there was little other training related to care that occurred. The provider stated that if any information related to care was needed, he found out this information and then passed it on to staff. Induction for new staff was also inadequate. Staff were on duty who had not received any formal training in health and safety issues and had not been supernumery on their first few shifts. There was a record of issues they had been told about when first starting but this did not allow them to get to know residents care needs. The provider stated that new staff were supervised when first on duty; however, on the second day of the inspection visit, it was noted that two of the three staff on duty were new starters. Three staff files were examined and showed that there was insufficient recruitment information available. None of the files had two written references and two did not have a full employment history. Two did not have a Criminal Record Bureau (CRB) check and there was also no Protection of Vulnerable Adults (POVA) check in place on the files pending the arrival of a full CRB disclosure. The provider had a computerised system for applying for CRBs that showed applications had been sent but no information had been received back. Having staff on duty without checks is unsafe practice and puts residents at risk of potential abuse. An immediate requirement notice was therefore issued to ensure that the process for obtaining the necessary information was commenced. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 21 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, 33, 35 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of a registered manager and proper quality assurance processes did not ensure that the home was run in residents’ best interests. EVIDENCE: The home had been without a manger for over a year and the provider was currently taking on managerial duties. He stated that he wanted to appoint the right person and although he had seen potential applications, he had not considered any of them to be suitable. The written information supplied by the Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 22 home stated that recruitment of a manager was an area that the home needed to improve on. There no clear plan for looking at quality assurance or how to improve the service. The annual quality assurance assessment supplied by the home prior to the inspection visit contained minimal information and it was not clear how quality assurance was to be addressed or how the service would improve. There were no surveys available and the views of visitors and visiting professionals were not available. The provider stated that he tried to be informal when asking the views of residents and had no written record of any feedback about the service. However, some ‘thank you’ letters seen from March 2007 made positive comments stating that staff showed ‘tolerance and patience’. Three residents’ financial records were examined and showed that a record of money due to each resident was recorded and there was space for two staff to sign when this was being administered. However, in practice only one member of staff was actually signing the record. The total amount of cash for all residents was stored together in one lump sum rather than individually in separate amounts but there was a record of the total amount stored. Receipts of individual purchases were available for one resident but there were none available for the other two. Cash was stored securely. The health and safety of those involved with the home was generally addressed. Staff undertook training in fire safety, infection control, first aid, food hygiene and moving and handling, although it was noted that new staff had not had any health and safety training. These staff must be a priority for the next training in mandatory areas. Maintenance records were examined and showed that fire equipment was checked in September 2006, gas safety in October 2006 and portable appliances in April 2007. Risk assessments were in place for the building and accidents and incidents were recorded and information on how to report accidents was available. Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 1 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 X X 3 Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 24 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 OP16 Regulation 22 (3), (4) & (8) Requirement A full summary of complaints and the action taken to resolve them must be available to meet legal requirements and ensure that concerns are taken seriously. The Registered Person must ensure that the premises are kept in a good state of repair externally and internally to ensure residents accommodation is safe and comfortable by addressing: • The worn stair carpet • Furniture in need of refurbishment or replacement • Scratched paintwork Previous timescale of 30/7/06 not met. Timescale extended to 01/09/07. Timescale for action 01/09/07 2. OP19 23 (2) (b) 01/09/07 3. OP29 19 (1) & Schedule 2 All staff employed must have two 05/07/07 written references, a criminal record certificate, a completed application form and evidence of identity available on file and for inspection to ensure legal DS0000033891.V340167.R01.S.doc Version 5.2 Page 25 Old Rectory, The requirements are met and residents safeguarded. (Previous timescales of 30/08/05 and 30/06/06 not met. Now immediate). 4. OP30 18 (1) (c) (i) There must be a training programme in place to ensure that care staff receive training appropriate to their work that includes training on care issues as well as health and safety matters, which will ensure residents are cared for competently. The registered person must maintain and establish a system for reviewing and improving the quality of care at the home to ensure it is run in residents’ best interests. 01/11/07 5. OP33 24 (1) 01/09/07 Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 26 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 OP8 Good Practice Recommendations Care planning records should hold comprehensive information on social history and individual preferences. Risk assessment tools for pressure sores and nutrition should be utilised to assist in monitoring residents’ physical health. Two people should sign and date hand written medication administration record (MAR) charts to minimise risk of errors. Eye drops should be labelled with date of opening to ensure they are used within their expiry date. A medication refrigerator should be purchased to ensure medicines are stored safely. Staff should always knock on residents’ bedroom doors to maintain privacy. Staff should receive training on bereavement. This is a previous recommendation and has not yet been addressed. A wider range of activities and entertainment should be considered to enhance the quality of residents’ lives. The menu should be reviewed and amended to cater for cultural needs and offer a wider range of desserts for those on specialist diets. Staff, including the cook, should receive training on nutrition to ensure nutritional and cultural dietary needs are catered for. Staff should have safeguarding adults training updated DS0000033891.V340167.R01.S.doc Version 5.2 Page 27 3. OP9 4. 5. 6. 7. OP9 OP9 OP10 OP11 8. 9. OP12 OP15 10. OP15 11. OP18 Old Rectory, The annually. 12. OP19 A written programme of routine maintenance and renewal of the fabric and decoration of the premises should be developed. This is a previous recommendation and has not yet been addressed. The identified areas should be odour-free to ensure residents’ comfort. The laundry system should be reviewed to ensure residents do not lose clothing. Soap and towels appropriate for communal use should be available at all times in communal toilets to prevent the spread of infection. There should be a proper induction programme in place that ensures new staff are fully conversant with health and safety matters before working unsupervised. A registered manager should be appointed as soon as possible to ensure the home is well run. The views of residents, relatives and visiting professionals should be sought to assist with quality assurance processes. Two members of staff should sign residents’ financial transactions and there should be receipts available for individual purchases to ensure financial records are accurate and detailed. All staff should be fully conversant with health and safety matters including moving and handling, first aid, food hygiene, infection control and fire safety before working unsupervised to ensure their own and residents’ safety. 13. 14. 15. OP26 OP26 OP26 16. OP30 17. 18. OP31 OP33 19. OP35 20. OP38 Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Old Rectory, The DS0000033891.V340167.R01.S.doc Version 5.2 Page 29 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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