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Inspection on 04/07/06 for The Squirrels Care Centre

Also see our care home review for The Squirrels Care Centre for more information

This inspection was carried out on 4th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Systems implemented at the last inspection to the home pertaining to the deployment of staff at lunchtime and the majority of residents eating their meal in the dining area have continued to prove satisfactory. Meals provided to residents are appetising and plentiful and resident`s comments are complimentary. The majority of staff working at the care home had been employed at The Squirrels for some time. This provides consistency and continuity for residents. The home`s environment is good and provides a homely and safe environment in which to live in.

CARE HOMES FOR OLDER PEOPLE Squirrels Care Centre (The) Warley Road Great Warley Brentwood Essex CM13 3HX Lead Inspector Michelle Love Key Inspection 4th July 2006 10:00 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 Squirrels Care Centre (The) DS0000018113.V303420.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. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Squirrels Care Centre (The) Address Warley Road Great Warley Brentwood Essex CM13 3HX 01277 224308 01277 261353 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) www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Mrs Jackalynn Gray Care Home 58 Category(ies) of Old age, not falling within any other category registration, with number (58) of places Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Personal care to be provided to no more than fifty eight service users over 65 years. Total number of service users for whom personal care is to be provided shall not exceed 58. 10th October 2005 Date of last inspection Brief Description of the Service: The Squirrels Care Centre provides personal care and accommodation for up to fifty eight older people. The home is a very large listed building, set within beautiful grounds, which are located some distance from shops and public transport. The home provides transport to both staff and visitors. There is sufficient car parking facilities to the front of the property. The home provides single and double bedrooms with en-suite facilities for all service users. In addition to service users individual bedrooms, there are three large lounges with designated dining areas. The home provides a passenger lift so that all floors can be accessed. The homes pre inspection questionnaire details that the range of weekly fees charged to residents for their accommodation and care at The Squirrels is between £413.00 to £640.00. Additional charges incurred by residents include hairdressing, chiropody, personal toiletries, sweets, magazines and newspapers. The homes Statement of Purpose and Service Users Guide is located within the homes main reception area. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced `key` site visit was conducted by Michelle Love and Carolyn Delaney, inspectors and lasted approximately 10 hours. A tour of the premises was undertaken throughout the day and a number of records pertaining to care plans/risk assessments/healthcare records, staff employment files, records of staff training, menu’s/nutritional records and the homes medication storage facilities and records were inspected. The inspection was conducted with the registered manager, however both senior staff and care staff were very helpful and co-operative throughout the day. Following the inspection a number of questionnaires/surveys were forwarded to visiting professionals and resident’s relatives, requesting their views as to the running of the home. It was disappointing to note that only two surveys were received by the Commission for Social Care Inspection, however comments raised have been incorporated into the main body of the report. What the service does well: What has improved since the last inspection? Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 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 Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 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, 3, 5 and 6 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose and Service Users Guide needs to be reviewed and updated. The home has a system for assessing prospective residents, however an assessment was not completed for the newest resident. Prospective residents and their relatives/representatives have suitable opportunities to visit the home to ensure that the home is suitable for their needs and requirements, however this is not evidenced and remains unclear. EVIDENCE: The homes Statement of Purpose and Service Users Guide was observed to be readily available, however it remains on the previous registered providers `headed` paper and not in line with other documents examined at other Southern Cross Healthcare homes. A revised copy of both documents must be undertaken and copies forwarded to the Commission. On inspection of six individual care files for residents, a pre admission assessment was only available for five residents. This is unacceptable and must be addressed for the future. The registered provider/manager must ensure that all prospective residents are assessed prior to admission and there Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 9 is written confirmation to the resident stating that the registered provider can meet the needs of the resident and that the home is suitable. In addition to the pre admission assessment and where applicable, assessments from individual resident’s placing authorities were available. Pre admission assessments varied in quality and detail and in some cases information was not completed i.e. medication plan, client full body check, eating and drinking and activities. Additionally it was unclear as to whether prospective residents and/or their representatives had visited the home prior to admission or provided with a copy of the homes brochure/Statement of Purpose/Service Users Guide. The home does not provide intermediate care at this time. Squirrels Care Centre (The) DS0000018113.V303420.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 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home has a clear care planning process, however care plans continue to vary in the amount of detail recorded and in two cases no care plan was completed. It was unclear in some instances as to whether or not individual resident’s health care needs are consistently met. The homes medication storage systems and record keeping were seen to be satisfactory, however the home’s administration of medication procedures needs to be reviewed. EVIDENCE: Since the last inspection to the care home, a new care plan format has been introduced by the registered provider. It was concerning to note that no care plan and risk assessments had been devised for two resident’s. This is unacceptable and must be addressed for the future as it is crucial and important that care plans are devised for individual residents, depicting their care needs relating to personal/physical care, social, emotional and healthcare needs etc. Additionally the care plan must include clear guidelines for care staff as to how care should be delivered. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 11 Not all formal assessments relating to pressure area care, dependency, moving and handling, nutrition, continence and falls had been completed for individual residents. The quality of information recorded within individual care plans was observed to be inconsistent and lacked clarity and detail i.e. the pre admission assessment for one resident indicated that the resident required encouragement to eat and drink, yet this was not detailed on the care plan. The care plan also made reference to the resident being prone to self neglect, however it was unclear as to how this manifested and what staff support was actually required. Daily care records were observed to not be written in line with Southern Cross Healthcare requirements i.e. after every shift and on a daily basis. The quality of recording varied according to the person who had written the notes. Records did not always include staff’s interventions and outcomes. Risk assessments were not devised for all areas of assessed risk i.e. risk assessments for one resident were devised pertaining to falls and pressure sores. However the resident’s care plan made reference to their nutritional assessment being cause for concern and them displaying inappropriate behaviours on occasions. One survey/questionnaire received from a visitor/relative highlighted that they were unsatisfied with the overall care provided at the care home. Additionally it detailed that they are not always consulted about their member of family’s care and are not always kept informed of important matters affecting their relative. It was unclear in some cases as to whether or not health care needs for individual residents are being met i.e. records for one resident indicated that a GP visited as a result of them having swollen genitalia/infection and that medication had been prescribed. No information was recorded detailing the outcome e.g. that the infection had cleared up and the timescale. Additionally accident records do not always include staff’s interventions, treatment and outcomes. The Commission recognises that the homes system for recording resident’s accidents is well organised and maintained. The homes medication administration records were noted to be well maintained with no omissions of signatures. The records for controlled medications were also satisfactory and an audit carried out indicated that all medications have been given as prescribed. Inspectors noted that the a.m. medication for residents was administered later as a result of staff shortages and that medication at lunchtime was given at the appropriate time. The concern was that the time span between medication being given in the morning and at lunchtime was too short. The registered provider must ensure that this is reviewed and avoided wherever possible. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 12 The container provided by Boots Pharmacy for the disposal of the homes medication is not suitable so as to ensure the safe storage of medication until it is picked up by the pharmacist. Squirrels Care Centre (The) DS0000018113.V303420.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 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 area is poor. This judgement has been made using available evidence including a visit to this service. Residents do not receive a programme of stimulating and meaningful activities, which meet their needs. Residents receive a varied diet. EVIDENCE: Inspectors were advised that since 2.7.06 Southern Cross Healthcare have implemented a new four week menu. At the time of the site visit the registered manager had not been notified of the homes food budget and it was unclear as to who would provide cover when the chef/assistant chef were on annual leave or off sick. Inspectors were advised that as a result of not having up to date copies of the new menus, the chef had devised an interim menu. At the time of the inspector’s arrival to the home (08.00), some residents were noted to be sitting in the dining room waiting for breakfast. Residents were noted to have not been given a cup of tea and breakfast was eventually served at 08.55 a.m., however some residents had been waiting for at least 55 minutes. Residents are given a choice of meals at breakfast, lunch and teatime. Inspectors were advised that alternatives to the menu are available. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 14 Inspectors observed at both breakfast and lunchtime that two residents did not appear to have either meal. Following discussions with care staff it was unclear as to whether or not this is a regular occurrence and what measures are being undertaken by care staff to ensure that resident’s nutritional needs are being met. The lunchtime meal provided to residents was observed to be plentiful and appetising. Both inspectors sampled the choices available (sausage plait and macaroni cheese). It was positive to note that tables were attractively laid and presented and condiments were readily available. In addition jugs of orange juice were placed on individual tables. It was disappointing to note that residents were not offered a choice of whether or not to have gravy with their sausage plait. Drinks for residents were readily available throughout the day, and care staff were observed to support and assist individual resident’s promptly and with due care. All residents spoken with at the time of the site visit were very complimentary regarding food provided and of the chef. It was disappointing to note that there is very little in the way of activities provided to residents. On the day of the site visit, one member of care staff was observed to paint a few residents nails in the morning, but generally residents were sitting in lounges with little in the way of stimulation provided. Records provide little evidence and it was disappointing to note that care staff appeared to have no motivation or time to undertake this task. The registered manager advised inspectors that a person had been recruited as an activities co-ordinator and was due to start week commencing 3rd July 2006, however due to unforeseen circumstances they are not taking up the appointment. It is evident that the home, have been unable to recruit to this post for some time. Squirrels Care Centre (The) DS0000018113.V303420.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 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 area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a complaints and protection of vulnerable adults policy and procedure. EVIDENCE: The home has been issued with a new complaints policy and procedure. Records indicate that since the last inspection the home has received 4 complaints. There was good information recorded pertaining to the specific nature of the complaint and the homes response. In some cases no information was recorded relating to the outcome and there was no log of complaints detailing the number of complaints received, time for response, outcomes i.e. substantiated, partially substantiated etc. The home has a protection of vulnerable adults policy and procedure and local guidelines were observed to be readily available. On inspection of a random sample of staff files, it was evident that not all staff had received protection of vulnerable adults training. Squirrels Care Centre (The) DS0000018113.V303420.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well maintained, safe and homely environment. EVIDENCE: On inspection of a random number of residents bedrooms all were observed to be individualised and personalised. Some bedrooms/en-suite facilities were noted to have no hand towels or face flannels readily available for residents use. Residents spoken with were complimentary regarding the home environment and their personal space. It was positive to note that a new carpet has been laid outside the laundry area and some resident’s bedrooms have also had new carpets fitted. The homes laundry area was noted to be well organised. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 17 Two minor health and safety issues were highlighted on the day of the site visit. These related to one double plug socket being very loose in a resident’s bedroom and the ground floor sluice room door being open with cleaning fluids easily accessible to residents. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels at the home during the day appear to be appropriate for the needs of residents, however staffing levels at night should be reviewed. Staff recruitment procedures are generally in line with regulatory requirements and protect residents. Mandatory staff training is generally satisfactory, however the induction processes at the home are still considered inadequate. EVIDENCE: On inspection of duty rosters it was evident that during the day on most occasions staffing levels are appropriate to meet existing residents needs. On the day of the site visit one member of care staff was absent. It was unclear as to what measures had been undertaken by the senior in charge to cover the shortfall. The registered manager was advised that as part of good practice procedures records should be kept to evidence this. One survey/questionnaire received from a visitor/relative to the care home expressed concern that on occasions there appear to be insufficient staff on duty. Staff rosters indicate that the home utilises agency staff regularly. The registered manager advised inspectors that only the homes Operations Director can authorise agency staff. This is contradictory to what inspectors have been led to believe by Southern Cross Healthcare. On the day of the site visit 35 residents were noted to be at the care home with 1 resident in hospital. Inspectors were advised that staffing levels have Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 19 been reduced to reflect this reduction in numbers. As part of good practice procedures the Commission should be notified. It was positive to note that staff working at the care home do not appear to be working excessive hours without a break and have at least one off duty day per week. The inspector was advised that currently two members of staff are on annual leave and one member of staff is on maternity leave. The registered provider should consider reviewing waking night staffing levels. Currently rosters evidence that there are 1x senior and 2x care staff on duty each night. The pre inspection questionnaire details that 5x people require two or more staff to undertake their personal care. Additionally the layout of the building has an effect on staff deployment and their ability to provide appropriate care. The registered person should advise the Commission in writing within 14 days of receiving this report as to how it intends to address this issue for the future. The staff rosters do not detail the full names of all staff working at the care home (domestic services). The homes pre inspection questionnaire details that only 29.17 of staff have attained a NVQ 2 or above qualification. A random sample of staff recruitment files were inspected. Records evidence that the majority of records as required by regulation had been sought. Issues highlighted relate to one persons file not containing sufficient evidence that they can work in the UK, employment history for another employee not fully explored, one reference received from a referee not detailed on the applicants application and employment history for one person unclear. In addition interview records were not available for the majority of files examined. It was evident that a number of staff files examined, related to employees who had no previous care experience or care experience with older people. The induction undertaken for these staff was noted to be insufficient and inadequate. The registered provider must look at reviewing its induction procedures for the future. Training records indicate that the majority of staff have received mandatory training, however it was evident that there are some gaps. There is clear evidence that little specialist training associated with those conditions of older people are undertaken by staff. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management arrangements at the home are satisfactory currently, however they are to change in the future. All staff within the home are formally supervised, but it is unclear that it is being used as is intended. Health and safety issues at the home were observed to be appropriate. EVIDENCE: The registered manager advised inspectors that she is due to leave the employment of the home in August 2006. Following the site visit the Commission was formally notified that the registered manager is to leave the care home at the end of July 2006. The home has employed a new manager to oversee the care home. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 21 There is a formal supervision system in place for all staff. On inspection of a random sample of records it was evident that senior staff do not understand the rationale behind what it is intended for. Records indicated that it is generally being used as a means to reprimand staff. The other areas such as the ethos of the home, identifying training needs, commenting on progress and good practices are not routinely recorded as part of the supervision process. A random sample of records as required by regulation i.e. safety certificates for the homes hoists, gas and electric, passenger lift, records of fire drills, emergency lighting etc were all deemed satisfactory. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X 1 X 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X 2 X 3 Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 23 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 OP1 Regulation 4&5 Requirement The registered person must ensure that the homes Statement of Purpose and Service Users Guide is reviewed and updated. The registered person must ensure that all prospective residents are assessed prior to admission. Previous timescale of 1.12.05 not met. The registered person must ensure that a detailed and comprehensive care plan is devised for all residents. Previous timescale of 1.12.05 not met. The registered person must ensure that all areas of risk are identified and detailed within the care plan. The registered person must ensure that the health and welfare needs of all residents are recorded and highlighted within the individual plan of care. The home must make DS0000018113.V303420.R01.S.doc Timescale for action 01/10/06 2. OP3 14 07/09/06 3. OP7 15(1) 01/10/06 4. OP7 13(4) 01/10/06 5. OP8 12 01/10/06 6. OP9 13(2) 07/09/06 Page 24 Squirrels Care Centre (The) Version 5.2 7. OP12 16(2)(m) arrangements for the recording and safe administration of medicines. This is in relation to ensuring that medication is administered to residents in a timely fashion (as per MAR sheet and prescribers instructions). The home must ensure that 14/10/06 arrangements are made to enable residents to access local, social and community activities and that residents receive a suitable range of activities, which meet their needs. This is in relation to the inadequate provision for community access and the inadequate provision of meaningful activities for the residents. Previous timescale of 1.6.05 not met. The registered person must ensure that the outcomes of all complaints are recorded and available at inspection. The registered person must ensure that all staff receive training pertaining to protection of vulnerable adults. The registered person must ensure that all areas of the home are free from hazards to residents safety. This refers to the sluice room being locked and COSHH items readily accessible to residents. The registered person must ensure that all equipment in the home is maintained. This refers to an electrical socket being loose which could cause a health and safety risk. The registered person must ensure that at all times there are appropriate numbers of staff on DS0000018113.V303420.R01.S.doc 8. OP16 22 14/09/06 9. OP18 13(6) 01/11/06 10. OP19 13(4)(a) 07/09/06 11. OP19 23(2)(c) 07/09/06 12. OP27 18(1)(a) 07/09/06 Squirrels Care Centre (The) Version 5.2 Page 25 13. OP27 18(1)(a) 14. OP29 19 and Sch 2 duty to meet the needs of residents. The registered person must look at reviewing the waking night staffing levels to ensure that it meet the needs of existing staffing levels. The home must ensure that robust recruitment procedures are adopted. 21/09/06 07/09/06 15. OP30 18(1)(c) 16. OP36 18(2) Previous timescale of 1.6.05 not met. The registered person must 01/02/07 ensure that all staff working at the care home receive both mandatory and specialist training which meets the needs of residents. The registered person must 14/09/06 ensure that all staff working at the care home receive formal supervision. The full ethos of supervision must be explored. 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. 3. 4. 5. Refer to Standard OP5 OP7 OP14 OP15 OP19 Good Practice Recommendations Evidence must be available which indicates that prospective residents and/or their representatives have the opportunity to visit the care home prior to admission. Ensure that daily care records are written daily and after every shift. Ensure that evidence is available to indicate that residents are consulted at all times and given choice and are part of the homes decision making processes. Ensure that the waiting time for residents to receive their breakfast in the mornings is reviewed. Ensure that hand towels/towels and face flannels are readily available and accessible for residents at all times. DS0000018113.V303420.R01.S.doc Version 5.2 Page 26 Squirrels Care Centre (The) 6. OP28 Ensure that 50 of staff working at the care home attain NVQ 2 or equivalent. Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Squirrels Care Centre (The) DS0000018113.V303420.R01.S.doc Version 5.2 Page 28 - 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!