Inspection on 12/05/06 for The Shrubbery

This inspection was carried out on 12th May 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 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 Shrubbery 11/09/08

The Shrubbery 10/10/07

The Shrubbery 03/05/07

The Shrubbery 11/10/05

The Shrubbery 05/05/05

The Shrubbery 19/11/04

The Shrubbery 13/05/04

The Shrubbery 03/02/04

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 The Shrubbery 66 College Street Higham Ferrers Northants NN10 8DZ Lead Inspector Unannounced Inspection 12th May 2006 08:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 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 Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Shrubbery Address 66 College Street Higham Ferrers Northants NN10 8DZ 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) 01933 317380 01933 317380 claire@rochmills.co.uk Rochmills Limited Natalia Emilia Mychajlyszyn Care Home 45 Category(ies) of Dementia (8), Old age, not falling within any registration, with number other category (31), Physical disability over 65 of places years of age (6) The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th October 2005 Brief Description of the Service: The Shrubbery is a care home in Higham Ferrers. There are local facilities and amenities including shops and there are public transport links to the neighbouring towns of Rushden and Wellingborough. The home provides personal care for up to 45 people over the age of 65 years; within this they are registered to provide care for up to 8 residents who have dementia and 6 with a physical disability. Fees range from £324.16 to £400 according to the level of care required. Accommodation is provided over two floors with a passenger lift and staircase for access to the first floor bedrooms. On the ground floor there are several communal rooms including two dining rooms, three lounge areas and a conservatory. There are gardens and level access to the main entrance with ample car parking for visitors. There are 33 single rooms of which 29 have ensuite facilities and 6 double rooms with 3 of these being ensuite. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Four hours were spent prior to the inspection reviewing previous requirements and recommendations, complaints and information provided by the service. The inspection took place over a period of seven hours as part of the statutory inspection programme. Three residents were chosen in order that their experience in the home could be monitored. This included looking at their records, talking to them and also to the staff concerning the care received. In addition to this staff rotas and staff training records were seen, as well as Health and Safety records. A limited tour of the environment was undertaken. What the service does well: What has improved since the last inspection? What they could do better: Care plans were poor, with little or no instruction being available for staff in order to meet resident’s specific needs. One resident chosen had been in the home for a few weeks but was yet to have any care plans provided. Staff were The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 6 unable to state what her particular needs were on questioning. They were also unaware of an identified need of one of the other residents chosen although it was listed in his assessment. Residents with a diagnosis of dementia have no special provision for this need. There are no environmental adaptations, specialist activities or specific care plans for their mental health needs. This results in their needs not being met and disruption to other resident groups in the home. For example, one resident stated that he was frequently disturbed by a resident with a dementia coming into his room when he was in bed. Several areas of the home are in need of maintenance. For example: the front door has a hinge missing at the bottom, a tumble drier vent opens in front of a resident’s window, bathrooms are very shabby and unpleasant, some carpets are very dirty and stained. The laundry area is badly organised with clean laundry spilling over into the corridor. There is no safe access to the garden, which is open to a busy main road. Waste bins in this area are not enclosed, leaving both domestic waste and clinical waste liable to access by vermin. Staff training records are unavailable and there are insufficient numbers of staff who have undertaken National Vocational Qualification training. There has been inadequate management of the home during the extended leave of the registered manager leaving systems and procedures to fail and therefore putting residents at risk. 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 Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 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 the following standard(s): 1,2 and 3. Standard 6 is not applicable in this home. Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents have the information needed to make an informed choice about living in the home. EVIDENCE: Comprehensive pre-admission assessments were available for the residents who were case tracked. These included Social Services assessments as well as assessments completed by the Registered Manager. Signed copies of the residents Terms and Conditions of residence were in evidence, that clearly stated the service offered and extra charges to be paid, as well as the room to be occupied and arrangements for terminating their residence. A Statement of Purpose and Service User Guide are available and set out clearly the service to be offered and extras charged. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 9 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 Quality in this outcome group is poor. This judgement has been made using available evidence, including a visit to the service. Staff do not have the necessary information to meet the needs of residents. Safe systems are in place for the control of medication in the home. Residents have their privacy respected. EVIDENCE: Comprehensive assessments of need had been completed for the residents chosen to case track, but there was no evidence that either the resident or their advocate had any input into this assessment. One resident had been in the home for two weeks but had no risk assessment or care plans to guide staff concerning her needs. Her assessment stated that she had dementia, but there was no detail of the type, stage or presenting difficulties or of her remaining abilities. Her daily record stated that she was “assisted with personal care” but did not clarify this. A second resident had an indwelling catheter. The care plan for this does not give guidance on the specific care of this and staff spoken to appeared unaware of its presence with one stating that he was doubly incontinent. This resident was also prescribed anticoagulant medication. Staff were unaware of the side effects of this medication and would therefore be unable to notify medical professionals of any potential problems. He had a pressure risk The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 10 assessment that identified him as being at risk, but there was no care plan in place to guide staff as to how to reduce that risk. On investigation it was found that he did in fact have a pressure relieving mattress and cushion in place. His daily statement has frequent references to his refusing meals but again there was no care plan in place to address this problem. The third resident had care plans in place but these were very basic and sometimes inappropriate. The care plan for a stoma was totally inappropriate and gave incorrect advice on its care. It did state to refer to the district nurse if problems persisted but there was no record of its action or the state of the surrounding skin. Despite the fact that this resident’s mental state had deteriorated over the last few weeks, and that she had been exhibiting challenging behaviour, her care plan for her dementia and challenging behaviour, had not been reviewed since the 24th March. This care plan was in any case very vague and made statements such as “Keep safe and Secure” without instructing staff as to how this should be achieved. There were records available that the Community Psychiatric Nurse and her General Practitioner had seen her and that she was being assessed for a more suitable placement. Residents with a diagnosis of dementia are cared for alongside the other groups of residents in the home and no specialist provision is made for this group. There are no environmental adaptations to enable them to maximise their remaining abilities, no specialist activities provided, inadequate or nonexistent care plans and little evidence of staff training in this area. This leads to not only inadequate care for this group but also sometimes disrupted care for the others. One gentleman spoken to reported that one resident kept coming into his room when he was in bed and that he found this very disturbing. Two of the residents had been weighed and the Registered Manager stated that the scales had now been repaired. The Registered Manager has implemented a revised system of tracking the medication in the home and clear audit trails are now in place. Medication records and storage systems were seen and found to be satisfactory. Staff were observed to be treating residents in a respectful manner and were observed to knock before entering residents rooms. Although the home has shared rooms all of these are currently singly occupied. Call bells are available in residents reach in order that they may call for assistance when needed. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 11 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 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Social activities and meals provide variation and interest for residents in the home. EVIDENCE: A record of individual preferences for food, clothing and activities is available in individual residents files. An activities co-ordinator organises such thing as Bingo, card games, board games and music and movement sessions. Residents enjoy a visiting entertainer and like to sing along with him. Photographs were on display that had been taken at a recent party held to celebrate the Queen’s 80th Birthday. Residents are able to sit in their own rooms or one of the communal lounges according to individual preference. One gentleman spoken to stated that he liked to watch sport on his own television and was looking forward to the World Cup. Visitors were observed to be coming to the home freely and records were available of residents going out with family and friends. One resident spoken to stated that three of the residents had been out for a walk with staff that morning and that she had enjoyed the sunshine. Residents spoken to stated that the standard of food was good and that they were offered a choice on a daily basis. Lunch was observed at the time of the The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 12 inspection and both looked and smelled appetising, except for those residents who required their meal to be pureed. They had been served fish pie, spaghetti hoops and pureed chips, which looked very unappetising. A discussion was held with the cook who agreed to provide mashed potato in future and stated that she had provided peas as well as the spaghetti and that staff had served the meal. The spaghetti was intended to be served with the alternative fried egg and not the fish pie. The meal was served at attractively set tables in one of two dining rooms or in the resident’s room according to personal choice. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 13 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 Quality in this outcome group is good. This judgement has been made using available evidence, including a visit to the service. Residents may be confidant that their concerns will be addressed and that they will be protected from abuse. EVIDENCE: The Commission for Social Care Inspection has received one complaint since the last inspection. This concerned the safety of residents and their access to the main road. The home was required to address the issues raised and ensure resident safety. There have been no other complaints or concerns raised in the home since that incident. A complaints procedure is available in the home and records kept of issues raised and their outcomes. A copy of the Protection of Vulnerable Adults guidance is available in the home and staff records demonstrate that staff have received training in this area. Staff spoken to were aware of their responsibilities in reporting any actual or suspected abuse in the home. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 14 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): All of these standards were monitored at this inspection. Quality in this outcome group is poor. This judgement has been made using available evidence, including a visit to the service. The environment does not provide a safe homely place in which to live. EVIDENCE: A limited tour of the environment was undertaken. A selection of communal sitting areas is available along with two pleasant dining rooms. Some of the resident’s rooms and the communal lounges and dining rooms have been redecorated since the last inspection, and some bedroom carpets have been replaced. Carpets in the lounge areas were very dirty and stained. Some furniture in resident’s rooms is very shabby and worn, for example the bed in an upstairs room had a broken divan base, and other furniture was chipped and scratched.. A conservatory is provided but as this does not have blinds or air conditioning, cannot be used on sunny days as it becomes very hot. Requirements have been made concerning these issues. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 15 Bathrooms are very shabby, dark and unpleasant. In particular the bathroom next to the cleaners store had a badly stained floor and unpleasant odour. The hot water temperature in this bath was checked after running for a few minutes and found to be only 40C (using the homes own bath thermometer). This is not hot enough to bathe in comfortably. Out of a total of thirteen light bulbs in one of the dining rooms, only one was found to be working. This room would therefore be very dark in the evening and on cloudy days. Requirements have been made concerning these issues. A ventilation flue for the tumble dryer has been installed close to the main entrance to the home. This large metal pipe finishes outside a residents window on the first floor, spoiling her view and discharging its fluff all over her window, into her room if the window is open and also all over the wall and adjacent roof. A large hole in the wall where this pipe enters the house has been left unfilled and is very unsightly. Requirements were made concerning this at the last inspection and remain outstanding. Although the home is set in its own grounds, all residents are not able to access the garden areas as they are not secure and do not offer level access. The garden areas are not well cared for and along with the poorly maintained outside of the building do not provide a welcome to visitors .A resident spoken to expressed his disappointment that more of the residents could not access the garden owing to its openness as he enjoyed being outside and would appreciate their company. Requirements were made concerning this at the last inspection and remain outstanding. Household and clinical waste is stored in open, broken containers in the garden and presents the risk of access by vermin. A requirement was made concerning this. Resident’s rooms seen had evidence of personalisation in the form of pictures and ornaments on display. Some of the residents have their own television sets and one gentleman said he enjoyed watching his own choice of programmes. Locks are provided on resident’s doors to ensure privacy, but in two cases these were of an unsuitable design and could lead to residents being accidentally locked in. A requirement was made concerning this. The main entrance door of the home had a missing hinge at the bottom, making this a security risk to residents and staff as it could be pushed away. A requirement was made in this respect. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 16 The laundry area is badly organised with clean laundry spilling out into corridor areas in the home, giving an untidy appearance, and leaving it open to contamination. A requirement was made in this respect and remains outstanding. Staff hand washing facilities were provided throughout the home. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 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 Quality in this outcome group is adequate. This judgement has been made using available evidence, including a visit to the service. Staffing levels and recruiting practices protect residents in the home. Staff are not all adequately trained to meet resident’s needs. EVIDENCE: Duty rotas demonstrated that there are six staff in the morning, five in the afternoon and evening and three at night. These levels are calculated using the Residential Care Forum guidance tool and are based on resident dependency. There are seven staff currently employed who hold a National Vocational Qualification in care in addition to two overseas qualified nurses. In addition seven more staff are currently working towards this award. There are however twenty- eight care staff employed and this level of qualification falls far short of the required 50 of carers qualified. There were no up to date records of staff statutory training in moving and handling, fire, food hygiene, health and safety, Control of Substances Hazardous to Health or First Aid. The Registered manager reported that Moving and Handling training was updated in December and that some staff had recently attended Control of Substances Hazardous to Health training. She stated that only two members of staff hold a First Aid certificate at present. One member of staff spoken to confirmed that she had completed fire and moving and handling training as well as a one day introduction to dementia, but that she had not done food hygiene or first aid training, despite her having The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 18 been employed in the home for two years and her being employed as a senior carer since November 2005. A second carer who had been employed for one year confirmed that she had completed fire and moving and handling training and that she had done food hygiene and first aid training with a previous employer. She had not undertaken any dementia training. Both of these carers confirmed that they were working towards National Vocational Qualifications in care at present. Requirements were made concerning staff training. A selection of staff files was seen and these demonstrated that Criminal Records Bureau checks had been completed for these staff members. Information on employment history and health status as well as equal opportunity information was available in these files. Work permits were available for overseas staff and references had been taken up prior to employment in order to protect residents from potential harm. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 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 and 38 Quality in this outcome group is poor. This judgement has been made using available evidence, including a visit to the service. The Registered Manager tries to ensure that the home is run in the best interests of the residents, where issues are within her control, but owing to an extended period of absence, the staff in the home have lacked direction and the management of the home has been allowed to become unsatisfactory. EVIDENCE: The Registered Manager is a First Level Registered Nurse with many years experience of caring and management. Staff and residents confirmed that she is available and willing to listen to them at all times. As stated above, she has been on extended leave of absence and the home has been inadequately managed in her absence. A requirement has been made in this respect. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 20 An annual report was available that included the results of resident surveys. In addition to this the Registered Manager confirmed that resident and staff meetings are held to ensure that everyone has the opportunity to air their views. A suggestions box is situated in the reception area of the home. Resident pocket money accounts were seen. Two signatures recorded for each transaction and receipts are available for expenditure, in order to protect both residents and staff. Evidence was seen that the area manager had audited these accounts and a sample checked on inspection was satisfactory. There was no evidence that staff received formal supervision and those staff members spoken to confirmed that this was the case. A recommendation has been made concerning this. As stated above, there is little evidence that staff have received Moving and Handling training or that all residents have had a moving and handling assessment completed. Records of the testing of fire alarms and emergency lighting were seen and found to be satisfactory. Maintenance records for these facilities were also available. The fire officer had visited recently and was satisfied with fire arrangements in the home. Hot water temperatures in the home are not maintained at the required temperature to prevent Legionella, while providing comfortable and safe temperatures for residents use. Although outlets are fitted with thermostatic controls, these do not appear to be working correctly. A requirement has been made in this respect. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 2 3 2 2 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 3 1 X 2 The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 22 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 OP7 Regulation 15(1) Requirement All residents must have plans of care formulated to guide staff on meeting their needs. These care plans must be individual and specific to the resident, be regularly reviewed and have evidence of the resident or their advocate having input into them. The unsuitable locks provided on two resident’s bedroom doors must be replaced to ensure their safety. Bathrooms must be thoroughly cleaned and refurbished if necessary in order to provide pleasant places in which to bathe. Adequate lighting must be provided to ensure resident comfort and safety. A plan of maintenance and redecoration must be submitted to the Commission for Social Care Inspection to address the shabby paintwork and décor in the home. Previous timescale of 14/11/05 not met. Safe access must be provided to DS0000012910.V294679.R01.S.doc Timescale for action 14/06/06 2 OP24 23(3)c 01/06/06 3 OP24 23(2)j 01/07/06 4 5. OP25 OP19 23(2)p 23(2) b &d 01/06/06 01/07/06 6. OP19 23(2) o 01/07/06 Page 23 The Shrubbery Version 5.1 7. OP19 23(2)a 8 OP26 13(1) 3 9. OP26 23(2) 10 11 OP19 OP30 23(2)b 19(5) b 12 13 OP38 OP28 18(1) c 19(5) b 14 OP31 8(1) the outdoor space at the home, and attention must be paid to the maintenance of the garden. Previous timescale of 01/12/05 not met. An alternative method of venting the tumble dryer must be found to remove the risk to the resident in the room affected by the vent, and to restore the view from her room. Repairs to the brickwork around this vent must be made. Previous timescale of 14/11/05 not met. Household and clinical waste must be stored in a manner that prevents access from vermin and the spread of disease. The laundry area must be reorganised to remove the necessity of clean laundry being stored in the corridor. Previous timescale of 01/01/06 not met. The main entrance door to the home must be repaired in order to protect residents and staff. Evidence must be available that all staff have received statutory training and updates in Moving and Handling, Fire, Health and Safety, Food Hygiene, Control of Substances hazardous to Health and First Aid. A qualified First Aider must be on duty at all times within the home. A plan to address the shortfall in National Vocational Qualified staff in the home must be submitted to the Commission for Social Care Inspection. Arrangements must be made to provide full time cover for the Registered Manager in her absence, to ensure the smooth running of the home for the DS0000012910.V294679.R01.S.doc 14/06/06 01/06/06 01/07/06 01/06/06 01/08/06 01/08/06 01/07/06 01/06/06 The Shrubbery Version 5.1 Page 24 15 OP38 13(4) a benefit of the residents. Circulating and outlet temperatures of hot water must be maintained at the recommended temperatures to ensure the safety of residents and staff. 01/06/06 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. Refer to Standard OP21 Good Practice Recommendations It is recommended that bathrooms are made more homely in order to make them a more pleasant place in which to bathe. Residents with a diagnosis of dementia should have care plans in place to address their mental health needs. These plans should focus on their strengths as well as weaknesses. Environmental adaptations should be available to meet the needs of those residents with a diagnosis of dementia. Evidence should be available that all staff caring for those residents with a diagnosis of dementia have received adequate training in the specialist care of this group. It is recommended that residents with a diagnosis of dementia should be cared for in a dedicated area of the home in order that both their specialist needs and the needs of other resident groups may be met. Dirty, stained carpets within the home should be cleaned or replaced as necessary. The problem of excessive heat in the conservatory should be addressed. Shabby, broken furniture in the resident’s rooms should be repaired or replaced. Meals provided for those residents who require pureed food should be monitored to ensure that they remain appetising and attractive. Evidence of resident or their advocate being involved in planning and reviewing care, should be available. 2 OP7 3 4 5 OP8 OP30 OP8 6 7 8 3 4. OP20 OP25 OP24 OP15 OP7 The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 25 5 OP38 Evidence should be available that staff receive formal supervision at least six times a year. The Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Aylesbury Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury Buckinghamshire HP19 8JR 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 Shrubbery DS0000012910.V294679.R01.S.doc Version 5.1 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!