Inspection on 17/07/06 for The Red House

This inspection was carried out on 17th July 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Red House 23/06/08

The Red House 17/10/05

The Red House 02/06/05

The Red House 18/11/04

The Red House 15/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Red House Bury Road Ramsey Cambridgeshire PE26 1NA Lead Inspector Lesley Richardson Key Unannounced Inspection 17th July 2006 11:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Red House Address Bury Road Ramsey Cambridgeshire PE26 1NA 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) 01487 813936 01487 711504 www.bupa.co.uk BUPA Care Homes (CFCHomes) Limited Lorna Jean Smith Care Home 60 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (60), of places Physical disability (3), Physical disability over 65 years of age (60) The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Two named individual with category DE(E) That the age range of the three residents in the Physical Disability (PD) category is 60 - 65 years only. Date of last inspection Brief Description of the Service: The Red House is a large converted house and a second purpose built building to the rear, situated on the main road into the market town of Ramsey. It is owned by BUPA Care Homes and provides care and support, including nursing care for up to 60 residents over the age of 65 years. Fees for the home range between £610 and £700 per week. The most recent inspection report is available in the manager’s office for service users and visitors who wish to read it. The home has 60 single rooms, all with en suite facilities. Service user accommodation is on two floors in both buildings, the upper floors being accessible by stairs or lift. Forty-seven beds are located in the purpose built premises that were opened in May 1996 and 12 beds are in the older, original house, which was refurbished in 2000. There are a variety of communal areas available to service users, the smaller areas being on the upper floor. The home is set in its own grounds and is a ten-minute walk from Ramsey town centre. The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 11 hours and was carried out as an unannounced inspection on 17th and 24th July 2006. It was the key inspection for this home for the 2006-2007. 7 hours were spent with staff members, service users and undertaking a tour of the home. The inspection was conducted with the manager present. The home was asked to complete and return a pre-inspection questionnaire to the Commission before the inspection took place, and information given in the questionnaire has been used in the inspection report. Twelve comment cards from relatives and visitors, and fourteen comment cards from service users were returned. Five requirements and eight recommendations have been made as a result of this inspection. None of these requirements have been carried over from the last inspection. What the service does well: The home provides personal and nursing care for older people in a comfortable, pleasant and clean environment. Prospective residents are able to visit the home before moving there to make sure it is the right place for the to live. If they are not able to visit, families can do this on their behalf. Relatives and visitors to the home are welcome at any time and are able to visit in private if the so wish. A contract or terms and conditions of residence are made with all new residents, and a copy is kept at the home for reference. Almost half of the non-nursing care staff at the home hold a NVQ qualification in care at level 2 or above and more staff are completing this qualification. Staff training is given and updated in mandatory health and safety areas, such as fire safety, and areas that are particularly relevant to the people living at the home. This shows the staff members have the knowledge to care properly for the people who live there. Records are kept to show health and safety aspects of the home are maintained and safe for staff and residents. These include service and maintenance visits to equipment in the home and checks that the home’s own staff make. Most of the people who live at the home said they enjoy meals there, the food looks appetising and is changed if it is not a popular choice with residents. Choices are provided every day and alternatives are available if meals on the menu are not liked. The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 6 The home provides a range of activities on an almost daily basis. These include short trips out of the home and visits by entertainers. People who live at the home said there are always plenty of things to do. What has improved since the last inspection? What they could do better: Care records that give information about visits made by health care professionals, such as Dieticians, must be written in more detail. This explains to all staff members the advice being given, what information the person is looking for and the best way for staff to obtain the information. Similarly, information obtained about a person before they come to live at the home should be in more detail, as it then gives clear idea of how much and the type of care that person will need. Recording of information in other areas should also improve, especially where residents have concerns, are unhappy about something, or have preferences about how they would like to be cared for. Staff members who are responsible for care records should date and sign the entry to make sure responsibility can be tracked. Improvements must be made to staff training in prevention of abuse. Only staff members who have NVQ qualifications have had any training about this, and it is important for the safety of everyone who lives at the home that all staff have this training. Although training updates and specific training is given to all staff members, records identifying this have not been kept up to date. This must be done to show all staff have the qualifications and knowledge to properly care for people. The manager should also complete a managerial qualification to support her in the role. Checks are required to make sure people who live at the home are safe. These include safety checks, such as hot water temperatures, and recruitment The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 7 checks. Most of these checks are completed correctly and show everything is in safe working order or that people can safely work at the home. But, new boilers were recently installed in the home and some of the hot water in bathrooms and toilets was too hot. Gaps in the employment histories given by new staff on application forms must also be checked; this further reduces the risk to residents and means the home is strong on protecting the people who live there. 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 Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Red House DS0000024304.V306193.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 5 and 6 The outcome for these standards is adequate. The home obtains enough information to make a decision about whether it can meet the needs of prospective service users. EVIDENCE: Four service user records were seen during this inspection and pre-admission assessments were available in three of the files. An assessment was also seen for the fourth person during a hospital admission as their needs had increased. Three of the assessments completed by the home gave basic but not detailed information and assessments from health and social care supplemented or replaced the home’s own assessment and gave more detail. Dates and signatures, or name of the assessor were missing from the home’s assessments, making audit trail of care records difficult. Two service users said their family had visited the home before admission but were unable to confirm if contracts had been issued. However, these were seen in each of these service user’s administrative files. The home does not supply intermediate care. The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 The outcome for these standards is adequate. The care planning system must continue to improve for all service users to ensure all health, personal and social care needs can be appropriately met. EVIDENCE: Service users have individual care plans, three of the four seen during the inspection show they provide a satisfactory amount of information to guide staff in how to meet each identified need. The plans are reviewed on a monthly basis, but they don’t justify how a ‘no change in plan’ decision is made. Risk assessments are completed and generally relate to associated care plans, but again reviews do not show changed information or why action is not taken. For example, in one person’s records the nutritional risk score increased to a very high risk, but as the service user’s weight had not dropped the recommended action to seek dietician advice had not be taken. However, this had not been recorded in the risk assessment or care plan reviews. One person’s file did not have care plans to show staff how all the identified needs should be met. Risk assessments had been completed, but there was nothing in the care plans to show how two identified risks should be The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 11 minimised. One of these risk assessments involves treatment of a wound, but there is nothing to show, apart from one entry in the daily records, that the type of dressing being applied to this wound had changed. A wound chart was completed but not every time the dressing had been changed, and it also didn’t indicate that the type of dressing had changed. The limited records available for the wound indicates deterioration rather than an improvement. Another risk assessment indicates a concerning level of risk for the nutritional needs of this person and recommends professional advice, but there is nothing in the care plan or review notes to show what action that has been taken regarding this. Discussion with visitors to this particular service user revealed they felt her condition, nutritional intake and physical abilities had improved, but this was not shown in the care records. Recording of referrals to healthcare professionals and their subsequent visits to the home is haphazard. The outcomes of visits by these professionals is not always recorded and no indication of advice given or requests for information by them. This means staff may carry out tasks with little idea why they are doing so or whether they are doing so correctly. Service users said staff members are polite, nice and do everything they need them to do. Staff members were polite to people who live at the home during the inspection. Recording of medication administration is completed accurately and reasons for non-administration of medication documented with a reason for this. Records were up to date at the time of inspection and checks of the controlled drug register tallied with stock stored in the home. The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 The outcome for these standards is adequate. Social activities provide stimulation and interest for people living in the home, but limited consultation about interests’ means individual preferences may not be catered for. EVIDENCE: People who live at the home said they are able to take part in a range of activities and are able to decide whether to attend or not. Newspapers are delivered on a daily basis to people who request them and there is also a range of books available from a mobile library that visits the home every month. Trips outside the home are organised to a local museum, churches and garden centres. These trips tend to be local or of a short duration only at service users request. A monthly activity diary is placed in the foyer and service users own rooms, and it informs people of the activity, the venue, date and time. 64 of the people who responded to a survey sent out before the inspection said the home provided enough activities. One person felt there were never any activities arranged by the home that they could take part in, but no other comment was made and the questionnaire was made anonymously. The home records service users’ social interests and life histories, but information on the forms seen was basic and gave only a limited idea of family history and where service users had lived. There should be more detail in The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 13 these records to better enable staff to meet the social needs and expectations of service users. Despite the activities available, only one social care plan was available in the service users files seen, and unfortunately this contained no information that corresponded with the life history information about that person. The home has an open visiting policy and visitors are welcome at any time of the day. All the relatives and visitors responding in a survey before the inspection and two visitors to the home said they are always made to feel welcome at the home and can visit in private. Service users said meals served at the home are good, they have a choice and can request an alternative if they do not like the offered menu. A main meal took place during the inspection; food served contained a variety of food groups and looked appetising, and there were a range of alternatives available. Although the home has a large dining room on the ground floor and a slightly smaller one on the first floor, service users are able to eat their meals in the location of their choice. One person said she chose to eat in her own room as at 97 years of age she felt more comfortable not having to travel to the dining room. A comment on one response to the pre-inspection survey that meals on the menu were not always available was found to be correct, however kitchen staff said this was because they had found some meals were not at all popular and had been substituted with more favourable meals. Service users confirmed they are asked every day what they would like to eat. As mentioned in other areas in this report, service users are able to choose some things, such as what they would like to eat. However, choice is more limited in other areas, such as whether male or female staff members perform intimate personal care and one person who would prefer her bed in another position in her room. The manager said this person’s physical needs dictated the need for space around the bed, but she would discuss this with the service user to try to find a compromise. Although the service user commenting about having a male or female staff member said they had never let staff know their preference, the need for personal preferences to be recorded is paramount if service users are not to be placed in uncomfortable situations. The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 The outcome for these standards is poor. Written guidance for the protection of vulnerable adults is in place, although training is not given, thereby not ensuring staff have appropriate knowledge to keep service users safe. EVIDENCE: The home has had six complaints in the last 12 months; three were seen during the inspection and documentation showed the home had investigated and responded to them within an appropriate timeframe. Service users said they felt staff do not always listen to their concerns or that action would be taken to resolve concerns if they are raised, although they also said they would know who to complain to and would have no concerns about doing so. 71 of people responding to the pre-inspection survey said staff always or usually listened and acted on what they were told, although just over 21 (or 3 out of 14) felt that this was the case only sometimes. Everyone who responded to the questionnaire said they would know who to speak to if they were unhappy about something. It would appear from these comments that the majority of people who live at the home feel their concerns are dealt with appropriately, but nearly 25 , or one quarter, do not feel the same way and it is important for the home to ensure all service users concerns are acknowledged. There has been one Protection of Vulnerable Adults (PoVA) issue since the last inspection, which has been dealt with promptly and referred to the PoVA team immediately. However, no staff members have had training that enables them to protect service users from abuse or recognise abuse if it occurs. Although 45 of non-nursing care staff have a NVQ in care qualification that includes an The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 15 element of protection from abuse, this doesn’t include local guidelines and updates to refresh knowledge is not included. This training must be given to all staff members to reduce the risk to service users living at the home. The Red House DS0000024304.V306193.R01.S.doc Version 5.2 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 the following standard(s): 19, 25 and 26 The outcome of these standards is good. The standard of the environment within this home is good, providing service users with an attractive and homely place to live. EVIDENCE: The home is well decorated and maintained and all areas are accessible to people who live there, with large open communal spaces. It was clean, tidy and all areas were free from offensive odours. Temperature readings were taken from three sink hot water taps after hand checks of these taps identified they were too hot to hold a hand under. On the second visit of this inspection the hot water temperature was taken at these three sinks with a digital probe; two taps had temperatures of lower or equal to 44oc, and one tap had a temperature of 53.7oc. This is too hot and places service users at risk of scalding. The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 The outcome for these standards is adequate. Improvement has been made in staffing arrangements and this must continue to ensure all service users needs are met in full. EVIDENCE: Staff rotas show that staffing numbers in the home are at acceptable levels and above those identified as being required using the Department of Health Residential Forum tool. There has been a significant improvement in permanent staffing levels since the last inspection, so that service users have staff specifically allocated to care for them. There is at least one registered nurse on duty in the nursing unit on all shifts. Although the majority of service users responding to the pre-inspection questionnaire felt there were always or usually staff available when they needed them, just over 21 felt that there were only sometimes staff available when they were needed. Half of the visitors responding to the survey also felt there were not sufficient numbers of staff on duty. One service user commented about the length of time she sometimes has to wait before assistance is available, which then causes her discomfort and distress. The manager said staff members are allocated particular areas and should remain in that area unless they are on break, thereby reducing the possibility of service users having to wait for assistance. Information obtained prior to the inspection shows staff members have had a variety of training covering the use of equipment, health and safety, service user specific training, such as tissue viability and incontinence, and specific The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 18 training for nurses, such as venepuncture. Staff members confirmed training had been given, although records for 2006 have not been kept up to date and indicate no specific training has been given and some mandatory health and safety training has not been updated. The home has 19 (45 ) staff members with a NVQ qualification in care at level 2 or higher and 5 staff currently completing the training. NVQ in care qualifications include protection from abuse information. The staff files were seen for two of the home’s most recently employed staff members. Checks that are required to be made to ensure the safety of service users had been completed, although there was no evidence that gaps in employment histories had been explored. A full employment history, together with a satisfactory written explanation of any gaps in employment must be obtained. The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 35, 36, 37 and 38 The outcome for these standards is good. The systems for service user consultation are satisfactory with evidence that service user views are sought and acted upon, although improvement is required to ensure all service users benefit from the same experience. EVIDENCE: The manager is now registered with the Commission for Social Care Inspection. She has qualifications specific to older people and is registered with the Nursing and Midwifery Council as a registered nurse, but as yet has not gained a management qualification. An annual service user satisfaction survey is conducted by an independent organisation on behalf of BUPA, and the results are available in the home. The manager said that although the results are an overall corporate view and do not contain specific actions, the home compiles an action plan from issues The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 20 identified from the survey. The annual survey includes views of service users relatives and stakeholders in the community. The home also conducts separate relatives and residents meetings as another way to gain the views. The home conducts clinical supervision, which gives staff members’ guidance on completing tasks associated with care delivery. Supervision records are kept, although these are basic and do not address development issues, practice or give staff members the opportunity for one to one discussions with their line manager. Staff said they receive supervision, but not individual supervision that addresses the issues above. Service users entering the home are given written information about how the home takes care of their money and the procedures for debiting an account. Statements are sent on a monthly basis, detailing incoming and outgoing transactions, and any interest earned. Although all service users funds are placed into the same account, each service user using the system has a separate written account and record on the computer. Information provided prior to the inspection shows maintenance checks and service visits have been completed at required intervals, except electrical wiring. Records seen at the inspection show this has been completed and is satisfactory. Hot water checks are completed by maintenance and records indicate all outlet temperatures are below 44oc, but as shown in the environment section (19-26) hot water from taps in two bathrooms and one toilet were very hot to touch, with one tap being too hot to hold a hand under. When checked using a thermometer only one of these taps was of a temperature that would put service users at risk. The home must make sure hot water is either at a temperature safe for people to use immediately, or that risk assessments are undertaken to show service users are not at risk. The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 2 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 2 X X X X X 2 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 1 3 The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 22 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 OP8 Regulation 13(1)(b) Requirement Timescale for action 10/08/06 17(1)(a) 2 OP18 13(6) 3 OP25 13(4)(a) (c) The registered person must make arrangements for service users to receive where necessary, treatment, advice and other services from any health care professional. The registered person must maintain in respect of each service user a record which includes the information, documents and other records specified in Schedule 3. The registered person must 20/08/06 make arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. A training schedule must be provided by this date to show when staff members are to receive this training. 10/08/06 The registered person must ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety and unnecessary risks to the health or safety of service users are identified and DS0000024304.V306193.R01.S.doc Version 5.2 The Red House Page 23 4 OP29 19(1)(b) 5 OP37 17(2), (3)(a) so far as possible eliminated. The registered person must not employ a person to work at the care home unless he has obtained in respect of that person the information and documents specified in paragraphs 1 to 9 of Schedule 2. The registered person must maintain in the care home the records specified in Schedule 4 and ensure that the records are kept up to date. 10/08/06 20/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP3 OP7 Good Practice Recommendations The home should complete its own full assessment to ensure it can fully meet the needs of prospective service users. Care records should be dated with day, month and year, and each entry should be signed by the person writing it for auditing purposes. Reviews of care records should justify the decision made. Care records should be up to date and include all information about each need. Social interests and life histories should be documented in enough detail to allow individual activities. Care plans should be developed from this information. The home should explore service users wishes and preferences in greater detail. All concerns raised should be acknowledged and investigated to ensure service user satisfaction. Staffing levels should ensure service users have access to assistance at all times. The manager should complete a NVQ level 4 qualification in management. Staff supervision meetings should include all aspects of practice, philosophy of care in the home and career development needs. 3 4 5 6 7 8 OP12 OP14 OP16 OP27 OP31 OP36 The Red House DS0000024304.V306193.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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. 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