Inspection on 09/06/05 for Towneley House

This inspection was carried out on 9th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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

Towneley House 03/10/07

Towneley House 28/02/07

Towneley House 06/12/05

Towneley House 28/10/04

Towneley House 28/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Towneley House 143/145 Todmorden Road Burnley Lancs BB11 3HA Lead Inspector Pat White Unannounced 9 June 2005 9.30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Towneley House Address 143/145 Todmorden Road Burnley Lancs BB11 3HA 01282 424739 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Stephen Alfred Shillito and Mrs Barbara Karen Shillito Mrs Dianne Janet Patterson Care Home 22 OP DE(E) 10 12 Category(ies) of Old Age registration, with number Dementia of places Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 2. The service is registered to provide personal care for a maximum of 22 service users 3. Staffing levels must be maintained at the levels stated in the homes proposal, that is 3 care staff will be on duty at all times between the hours of 7.30 am and 10.00 pm and 2 waking night staff between the hours of 10.00 pm and 8.00 am, giving a total 444.5 care hours. In addition there should be a manager on shift for a minimum of 105 hours per week, a minimum of 30 domestic hours and 40 cooking hours. 4. The service is registered to provide care for 10 older people, not falling within any other category and 12 older people with dementia Date of last inspection 28 October 2004 Brief Description of the Service: Towneley House is registered to provide residential care for 12 elderly people and 10 elderly people with dementia. The home is of an older type building situated in close proximity to Burnley town centre and Towneley park. It comprises 3 floors, linked by a stair lift. Private accommodation consists of 11 single rooms, five of which were at least 10 sq ms, and 5 double rooms, two of which were under 16 sq ms. Nine single and four double rooms were en suite. Communal areas consisted of 2 lounges, a dining room and a smaller dining room/smoke room. Renovations and developments were underway to increase the amount of communal space, increase some bedroom sizes and enhance the facilities. The homes decor and furbishings will be improved as a result of the renovations. The registered person Mrs Karen Shillito and the registered manager, Mrs Dianne Patterson had both gained the Registered Managers Award. Good relationships were maintained with the psychological services for older people, and all other specialist practitioners appeared to be involved when appropriate. To assist in meeting the needs of the residents with dementia, assessment and training material from the Alzheimer’s Disease Society was in use. The home had a mini bus that enabled residents to enjoy a range of supported outings and activities to such places as the Trafford Centre, Bury market, the coast and country runs. Residents have the opportunity of an annual holiday abroad in recent years. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection, the purpose of which was to check: the progress of previous legal requirements and good practice recommendations, check some other important areas of life in the home that should be inspected over the year and other matters in the home which came to the inspector’s notice and check the progress on the renovations that had begun last year. The inspection took 9 hours and comprised of, talking to residents, a tour of the premises, looking at a small number of resident’s care records and other documents, and discussion with the manager and members of staff. Seven residents were spoken with, but only two were able to give their views on the home, and residents were observed in their daily activities. At the time of the inspection there were 16 residents living in the home. Comment cards were left in the home for residents and relatives. At the time of writing the report none had been returned. What the service does well: What has improved since the last inspection? Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 6 Some aspects of the premises had improved which directly benefited the residents. Some bedrooms had been decorated and maintenance jobs had been carried out. Beds and bedding had been replaced. Other previous legal requirements in relation to the environment had also been met. 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. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 4. Standard 6 was not applicable The home’s admission procedures ensured that residents were not admitted to the home without an assessment. However the in - house assessment did not fully determine whether or not the home could meet the mental health needs of a recently admitted resident. EVIDENCE: The records viewed showed that pre admission assessments were undertaken to assist the management team (the registered provider and the registered manager) decide whether or not the home could meet prospective residents’ needs. Social work assessments and in house pre admission assessments were undertaken with those residents who were admitted through care management arrangements. However for a recently admitted resident with a history of mental health problems the in – house assessment had not sufficiently addressed the mental health needs identified in the social work assessment, and it was not clear whether or not Towneley House could meet his needs. The registered person must demonstrate to the CSCI that this resident’s needs, both physical and mental health, can be satisfactorily met in the home. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 9 The in – house assessments seen did not include all matters listed in Standard 3.3 and it is strongly recommended that this is rectified. Positive steps had been taken to endeavour to meet the needs of the service users with dementia. Material from the Alzheimers Disease Society was used for assessment, meeting needs, activities and staff training. In addition the registered person had completed a 1year college based “ Community Mental Health” course. All care staff had completed an in house course on dementia run by the Alzheimers Disease Society. Some residents stated that they were well looked after and were satisfied with living in the home. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 The care planning process and documentation would benefit from simplification. The care plans need to include all aspects of residents’ personal, health and social care needs to ensure these needs are met. The residents’ health care needs were promoted and maintained, but this would be further enhanced by an improvement in aspects of medication management. EVIDENCE: All residents had care plans, and those with a diagnosis of dementia had detailed assessments and care plans on documentation produced by the Alzheimers Disease Society. Useful personal, life history was recorded. The care plan system would benefit from simplification and should include at least all the matters listed in Standard 3.3. The management team must ensure that all relevant aspects of the residents’ health, personal, and social care needs are detailed on the care plans. This must included pressure area care and mental health issues such as those relating to alcohol abuse and violence. Care plans were being reviewed regularly, but the recording system for the reviews and the transfer of relevant information to the care plans needs to be Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 11 improved. There was evidence that some residents had been involved in the compiling of their care plan. There was evidence that the district nurses were involved in the pressure area care of some of the residents and provided the appropriate advice and equipment. Continence was promoted and managed in the home with assistance from the specialist nurse. The care plans contained information about diet and food preferences but residents’ weights should be monitored and recorded regularly. The management team was planning to use information from the Alzheimers Disease Society to undertake detailed nutritional screening. Records showed that residents had access to all appropriate health care services. Medication management and administration was carried out to ensure the well - being and the safety of the residents, and all those staff administering medication had been on an accredited training course. However the systems must be improved in the following ways: The development of policies and procedures to include leave/visits, verbal changes and non - prescribed medication. The criteria for PRN (“when required”) and variable dose medication must be clearly defined and documented. The home’s monitoring and checking systems must be improved to eliminate errors and must include, the home checking the prescriptions from the GP prior to dispensing, the person in charge of medication ensuring there is always a supply of the prescribed medication so that residents are not given medication prescribed for another person and that residents are not given non prescribed medication. Medication no longer in use must be returned to the pharmacist. A number of good practice recommendations have also been made. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 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 standard(s) 12 & 15 Varied social activities were provided which were enjoyed by some of the residents. Some residents with dementia were not able to join in some of the activities. The food served was wholesome, nutritious and varied and the meals were prepared according to the residents’ tastes and preferences. EVIDENCE: Residents are offered a lifestyle in the home that matches their experience and expectations. Routines were flexible enough to suit individual preferences and residents could choose what time to rise and retire to bed, and whether or not to take part in activities. Previous leisure interests and hobbies were recorded on the care plans. Records showed that a variety of activities were arranged, such as entertainers, singers and trips out in the home’s minibus. Visits were made to shopping centres, pubs and local places of interest. Residents enjoyed annual holidays in Spain. However it is recommended that the home provides dementia specific activities for those who do not benefit from the activities enjoyed by the other residents. Those residents spoken with could not say whether or not they enjoyed the activities. The food served on the day of the inspection appeared wholesome and nutritious, with the main (cooked) meal being served in the early evening. Residents had the choice of a cooked breakfast. The menus showed variety Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 13 and were drawn up to suit residents’ preferences. with stated that they enjoyed the food. Some residents spoken Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 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 standard(s) None of the standards in this section were assessed EVIDENCE: None of the standards in this section were assessed. However no complaints had been made to the CSCI about the home and there had been no allegations or suspicion of abuse. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24 & 26 Work was in progress to extend and develop the property, and so improve the accommodation and facilities of the residents. Some improvements in the décor, maintenance and furbishing of the bedrooms had been made. To ensure the safety and comfort of the residents, the registered persons need to ensure that all parts of the home are satisfactorily maintained as far as is possible whilst the building work is progressing. EVIDENCE: At the time of the inspection the registered provider Mr Shillito was working on an extension and improvements to the home. These developments include a conservatory, an extended dining room, a passenger lift and an increase in some bed- room sizes. As a result, some parts of the home will not be redecorated or refurbished until after completion of these developments, such as the dining room and the reception hall. However the registered persons must ensure that satisfactory standards of decor and furbishing in the residents’ living areas are maintained as far as is possible. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 16 The area to the rear of the building was under construction and could not be used by residents. However safe access to the courtyard beyond was maintained. There was a patio area at the front of the building. There had been some improvements in maintenance and furnishings since the previous inspection and some legal requirements had been met. This included the redecorating of some bedrooms, repairs to WCs, the replacing of some beds and bedding and the replacing of some bedside lights. The cellar renovations were complete and provided a clean and bright storage area. Communal space was to be increased, but currently consisted of 2 front lounges, a dining room and a rear room with patio door and rear (smoking) lounge. This gave a satisfactory amount of communal space to each resident. The communal areas were furnished in a comfortable and homely style but residents would benefit from improvements to the decor and carpets in the two front lounges. Towneley House had one assisted bath, one assisted shower and one unassisted shower, for 22 residents. There was one toilet downstairs, with plans to install another downstairs WC as part of the developments. Most bedrooms had en suite facility. There were 11 single bed - rooms, nine of which were en – suite. Five were of the recommended size of 10 sq ms and six were under this size. There were 5 double rooms, four of which were en – suite. Three were of the recommended size of 16 sq ms and two were under this size. The bedrooms were comfortably furnished and some had been improved since the previous inspection as outlined above. More maintenance and refurbishment was planned and the registered persons must ensure that these are carried out for the comfort of the residents. They must also ensure that the identified repairs to the chair lift are carried out. The registered persons must provide to the CSCI written details of the progress and timescales of the phases of building work, and details of how this will be managed in relation to the comfort and safety of the residents. The home was clean and free from offensive odours and the laundry facilities were in good condition. These and the procedures ensured the control of infection. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 The staffing levels appeared to be adequate for meeting the needs of the current group of residents, but will need to be increased when more residents are admitted. Staff training and development had been progressed according to the needs of staff and the residents. Staff recruitment procedures were in accordance with the Care Homes Regulations and protected residents from staff who were known to be unsuitable. EVIDENCE: There was evidence that staffing levels were meeting the needs of the current numbers of residents, but that these would need to be increased when more residents are admitted to the home. Cooking and domestic hours appeared to be adequate to ensure standards in relation to cleanliness and food were met. There was evidence that over 50 of care staff were trained to at least NVQ level 2. Staff had training and development records which showed that most staff had undertaken training in dementia, updated moving and handling, first aid, health and safety and infection control. Some had completed a “protection of vulnerable adults” course. Staff spoken with confirmed that the management team was committed to training and development. However the management team needs to ensure that new members of staff have completed or will complete induction training within the first 6 weeks of employment which is in accordance with the “Skills for Care” (the former TOPSS) specifications. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 18 The management team were following thorough staff recruitment procedures in accordance with the Care Homes Regulations, to ensure the protection of the residents from unsuitable staff. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35 & 36 There was a new manager in the home who had the relevant qualifications and numerous years of management experience. The change of management appeared to have occurred without problems for either residents or staff. The frequency of formal staff supervision in the home could be improved. The management of residents’ finances must be improved to ensure safekeeping of their monies. EVIDENCE: Mrs Dianne Patterson became the registered manager in April 2004. She has the relevant qualifications and numerous years experience as a deputy manager. She has undertaken periodic training in relevant subject areas. The previous manager had been in post only for about 18 months and the home will benefit from stability and continuity of management. Mrs Patterson stated that she intended to gradually implement some needed developments and that this should be the best approach for residents and staff. The registered Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 20 person, Mrs Shillito also has the relevant qualification and is involved in the day - to - day running of the home. Staff stated that they had adapted to the change of management and confirmed that changes were being implemented at an acceptable pace. A quality survey involving resident questionnaires was about to be conducted. These questionnaires covered all the main areas of life in the home. The manager stated that there were plans to extend the survey to visitors and staff. Residents meetings were held every few months. Only one previous requirement with respect to medication was unmet from the previous inspection. Accurate records of residents’ finances were kept, and those viewed balanced with the amount of cash kept in the home. However due to residents having to close post office savings accounts, the registered person must ensure that alternative arrangements are made for residents’ savings and that in the meantime accumulated cash is stored securely. The home did not have a safe. Annual staff appraisals were carried out. The manager should ensure that formal one to one supervision according to standard 36 recommences. Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 2 3 x 2 3 x 3 STAFFING Standard No Score 27 x 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 2 x 2 2 x x Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 22 No 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 3 Regulation 14 (1)(a) & 17(1)(a), schedule 3, 3(m) Requirement Timescale for action 31 July 2005 2. 4 3. 7 4. 9 5. 9 6. 7. 9 9 The registered person must ensure that the in - house assessment includes a detailed assessment of mental health needs with those residents for whom it is relevant. 14 (1)(d) The registered person must demonstrate to the CSCI that Townwley House can meet the needs of the resident identified with a history of mental health problems. 15& The care plans must detail all 17(1)(a), relevant aspects of the residents schedule health, personal and social care 3, 3.(m) & needs, including those relating to (n) mental health and pressure areas. 13 (2) The medication policies and procedures must include leave / visits, verbal changes and non prescribed medication. 13 (2) The criteria for the administration of PRN and variable dose medication must be clearly defined and recorded. (previous timescale of December 2004 not met) 13 (2) The home must check the prescriptions prior to dispensing 13 (2) The person responsible for F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc 31 July 2005 31 July 2005 31 July 2005 31 July 2005 31 July 2005 Immediate Page 23 Towneley House Version 1.30 8. 9 13 (2) 9. 9 13 (2) ordering medication must ensure there is always a supply of prescribed medication Residents must not be given medication prescribed for another person or non prescribed medication. Medication no longer in use for current residents must be returned to the pharmacist The registered person must ensure that all bedrooms are satisfactorily maintained and decorated (Previous timescale 2 time scales partly met) The registered person must ensure that the identified repairs to the stair lift are carried out. The registered persons must provide to the CSCI written details of the progress and timescales of the phases of building work and details of how this will be managed in relation to the comfort and safety of the residents The registered person must ensure that residents are protected from hazardous substances and fit a lock on the laundry door. The registered person must ensure that the intended quality monitoring survey is carried out and that a report of this survey is sent to the CSCI The registered person must ensure that alternative arrangements are made for residents’ savings and that in the meantime cash is stored securely in the home. 10. 24 23 (2)(b) & (d) from the time of the inspection Immediate from the time of the inspection Immediate from the time of the inspection 31 July 2005 11. 19 12. 19 23 (2)(c), & 13 (4)(a) & (c) 39 (h) 31 July 2005 31 July 2005 13. 26 13 (4)(a) & (c) 30 June 2005 14. 15. 33 24 31 August 2005 16. 35 16 (2)(l) 31 July 2005 Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 24 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. 6. 7. 8. 9. 10. 11. 12. Refer to Standard 3 7 7 7 8 9 9 9 9 12 20 30 Good Practice Recommendations It is recommended that the in house assessment includes all the matters listed in standard 3.3. It is recommended that residents weight is monitored and recorded. It is recommended that the care plan recording and review systems be simplified and that all changes identified in the reviews are recorded on the care plans. It is recommended that the care plans include all matters listed in standard 3.3 It is recommended that detailed nutritional screening is undertaken It is recommended that the keys to medication are kept securely and only accessible to authorised staff. Medication requiring fridge storage should be kept in a lockable facility. Where drops are to be used in both eyes, separate bottles should be used for each eye to avoid cross-contamination. It is recommended that only designated (trained) staff apply creams after bathing. It is recommended that the management team provide suitable activities for individuals with dementia and cognitive impairment. It is recommended that the 2 front lounges are redecorated and the carpets repaired or replaced in these areas. The management team should ensure that new members of staff have completed or will complete induction training within the first 6 weeks of employment which is in accordance with the “Skills for Care” (the former TOPSS) specifications. The manager should ensure that formal one to one supervision according to this standard recommences. 13. 36 Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Unit 4 Petre Road Clayton-le-Moors Accrington BB5 5JB 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 Towneley House F57 F07 S9456 Towneley Hs V231524 9.6.05 Stage 4.doc Version 1.30 Page 26 - 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!