Inspection on 26/07/07 for Wall Hill

This inspection was carried out on 26th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Wall Hill 27/04/10

Wall Hill 18/02/10

Wall Hill 22/10/09

Wall Hill 15/06/09

Wall Hill 14/08/06

Wall Hill 24/10/05

Wall Hill 12/07/05

Wall Hill 23/11/04

Wall Hill 12/07/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Wall Hill Broad Street Leek Staffordshire ST13 5QA Lead Inspector Linda Clowes Unannounced Inspection 26th July 2007 08:45 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 Wall Hill DS0000005030.V347321.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. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wall Hill Address Broad Street Leek Staffordshire ST13 5QA 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) 01538 399807 care@wallhill.co.uk Wall Hill Care Home Limited Mrs Susan Jane Briand Care Home 31 Category(ies) of Dementia (4), Mental disorder, excluding registration, with number learning disability or dementia (1), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (9), Old age, not falling within any other category (31), Physical disability (9), Physical disability over 65 years of age (9) Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 9 PD - 1 of whom may be minimum age 50 years on admission 1 MD minimum age 55 years on admission Date of last inspection 14th August 2006 Brief Description of the Service: Wall Hill is registered to provide care and accommodation for 31 older people, 9 of who may have needs associated with a physical disability, and 9 of whom may have mental health needs. The home is located close to the centre of the historic market town of Leek in the Staffordshire Moorlands that has a wide range of community facilities, including shops, restaurants, pubs and other leisure amenities. There is good access to local bus services. The home also has its own minibus which is a well used and popular facility. The home consists of a two- storey building that has undergone considerable refurbishment to meet the needs of the service users. A passenger lift allows easy access to the first floor. There are 29 single bedrooms, 26 with en-suite facilities. There is 1 double bedroom. The environment is well maintained and decorated throughout. Attractive communal sitting areas are provided at Wall Hill, with four lounge areas and a large and attractive dining room that opens onto the rear grounds and patio area. The current fees were £375-£396 per week which does not include extra services such as hairdressing, chiropody, toiletries which were all available at extra cost to the residents. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced inspection and inspected against the National Minimum Standards for Care Homes for Older People and the Care Homes Regulations 2001. This was a key inspection and covered all of the core standards. The inspection of the home took place over a period of 8 hours and included an examination of records, service user care plans, personnel files and associated recruitment procedures, complaints files, health and safety records and a feedback session. The Commission had not received the Annual Quality Assurance Assessment (AQAA) document from the home for this current year. As a consequence, much information needed for the report had to be obtained on the day and it had not been possible to forward questionnaires to service users as would normally be the case prior to an inspection. However, the inspector spoke with the majority of the service users and staff working in the home during this visit. An inspection of the premises was also carried out. There were 29 people resident in the home and two vacancies. This inspection identified that the home should review its Statement of Purpose to include all matters required by regulation. It will also be necessary for the home to ensure that they give written confirmation to prospective service users that the home can meet their assessed needs prior to admission. It was identified that more robust procedures were needed in recruitment of care staff, particularly in relation to validity of work permits. Individual Fire Risk Assessments needed to be carried out on all residents and fire training for staff had not been carried out as required. Discussions with people who use the service identified high satisfaction rates regarding the quality of care in the home. Staff were positive regarding the support they received from management to enable them to do a good job. What the service does well: The people who lived in the home expressed satisfaction with the service and support they received. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 6 Mandatory training for staff was up to date and staff confirmed this. Complaints and grumbles were taken seriously and attended to promptly. What has improved since the last inspection? What they could do better: Individual Fire Risk Assessments need to be carried out Fire training should be provided on a six-monthly basis for day staff and threemonthly for night staff. The Statement of Purpose needs to be reviewed to contain all areas listed in Schedule 1 of the Care Homes Regulations 2001. Prescribed creams and aqueous creams must not be stored in communal bathrooms but should be safely stored. This will ensure that creams are administered as prescribed and will also eliminate risks of cross infection. Meat gravy should not be served to those people who had expressed the wish to receive a vegetarian diet. The first floor bathroom should be fully maintained in order to provide people who use the service with choice as to whether they wish to bathe in the bathroom on the first floor close to their bedrooms or whether they wish to walk downstairs. Further commitment should be given to NVQ training. Twelve of the twentyeight care staff had attained NVQ level 2 in health and social care. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 7 The record of alternative food served should be maintained in the kitchen diary rather than on undated, loose sheets of paper. Regular Residents Meetings would enable management to ensure that the home is run in the best interests of service users. Regular staff supervision should take place which covers all aspects of practice, philosophy of care in the home and career development needs. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 and 5. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A regular review of the Statement of Purpose and Service User Guide was needed to ensure that it contained sufficient and clear information in order that service users will know that the home can meet their needs. Management ensured that no one entered the home without having had a care needs assessment. It is important that they follow this up with written confirmation to the prospective service user that the home is able to meet their needs. EVIDENCE: The Statement of Purpose for the home was displayed in the entrance hall. This document needs to be regularly reviewed to ensure that it includes current information and a full description of the services provided and a statement as to the matters listed in Schedule 1 of the Care Homes Regulations. For example, an explanation what registration categories mean, what communal space is provided, relevant qualifications and experience of the registered provider, registered manager and staff working in the care home, the organisational structure, the age, range and sex of the service users for whom it is intended and whether nursing is to be provided or not. A Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 10 requirement has been made as part of this report in relation to this issue. (Requirement 1) Service users spoken with confirmed that they had visited the home prior to admission and had been satisfied with the admission procedures that settled them into the home. However, they had not received written confirmation from the registered person, having regard to the pre-admission care needs assessment, that the care home was suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. A requirement has been made in relation to this matter. (Requirement 2) Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users felt they were treated with respect and assisted to make decisions about their lives. Service users individual plans of care would benefit from further review to ensure that information is up to date and specific in order to provide explicit information regarding the current health, personal and social care needs of individuals. EVIDENCE: Without exception service users who took part in this inspection expressed satisfaction with the service and the staff who delivered the care. Service users felt safe in the home and several who had lived in other homes made in quite clear that they were much happier at Wall Hill. They considered that their privacy was respected and that staff were sensitive to their needs. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 12 Staff spoken with had an overall understanding of the needs of the people living in the home and were seen to be patient and kindly when interacting with them. It is imperative, however, that greater attention to detail is given to the Service User Plan to ensure that it provides current and explicit information regarding the health, personal and social care needs of individuals. It should also be a useful reference tool for staff. Several files seen on the day of the inspection had gaps in the records that were discussed with the manager A requirement has been made regarding this matter as part of this report. (Requirement 3) It was also noted that prescribed creams and aqueous creams were being stored in bathroom cabinets in communal areas. This is not acceptable practice as it presents a risk of cross infection. Prescribed creams should be stored securely and used only for the person for whom they are prescribed and a record maintained of their administration. A requirement has been made in relation to this issue. (Requirement 4). The teatime medication round was observed and it was noted that the administration and recording of medication was satisfactory. It has been recommended that in all instances medicines/tablets are transferred from the monitored dose system (MDS) using a medipot and not emptied and transported by hand to the service user. (Recommendation 1). There had been issues raised at the last inspection regarding the decanting of medication. This was in relation to taking medication out of their packets and storing in separate envelopes. This situation had been addressed by the home and was not an issue during this inspection. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefited from a relaxed and friendly ambience which gave them confidence to express their aspirations and preferences. A wholesome and appealing balanced diet was provided that was valued by the people who used the service. Community links were promoted by the home. EVIDENCE: A majority of service users in the home were spoken with on the day. Residents were relaxed and comfortable and were observed talking and laughing with care staff and management. It was apparent that people felt confident in their approaches to the care team that they would be treated with sensitivity and respect. There was an extensive social programme which was displayed in the hallway. Service users told the inspector about the entertainment provided, the movement to music sessions which they enjoyed and the trips out in the home’s minibus which they really looked forward to. Relatives and friends visited the home during the day and were made welcome. Visitors confirmed that they were very satisfied with the service provided to their relatives. They commented that they were always made welcome when they visited at whatever time. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 14 Everyone spoken with spoke about the good food that was provided. An inspection was made of the record of food provided which was nutritious and varied. Residents confirmed that they were offered choice and that there was sufficient. Specialist diets were catered for and personal preferences were accommodated. Several preferred their hot meal in the evening. Meals were served in pleasant surroundings and tables were set with tablecloths and napkins to provide a pleasurable experience. Discussions took place with the cook who confirmed that she regularly discussed with residents what should be added or removed to the menu and residents confirmed this. It was noted that the record of food that was served which was not on the main menu was kept on loose leafed sheets that were undated and a recommendation was made that this record be maintained in the kitchen diary. (Recommendation 2) Discussions took place regarding vegetarian options and a recommendation made regarding the use of vegetarian sauces/gravy. (Recommendation 3) Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s induction training encompassed issues regarding the protection of vulnerable adults from abuse and updates were included in future training. Care staff spoken with were aware of their responsibility to protect residents from abuse. The home’s complaints procedure was outlined in the Statement of Purpose/Service User Guide that was given to each service user. EVIDENCE: Staff had received Protection of Vulnerable Adults from Abuse training at induction and when undertaking their NVQ training. The complaints record was inspected but there were no entries and the manager confirmed that all grumbles and concerns were addressed before they became complaints. Service users and relatives confirmed that they were aware of the complaints procedure and who to complain to. They also considered that they would have no hesitation in raising their concerns knowing that they would be addressed seriously and promptly. The Commission had not received any complaints about the service since the last inspection. T Service users recently took part in the local election process by completing postal votes, with assistance from managers and staff as required. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 16 The manager was aware of the need to introduce advocacy services should these be appropriate where service users may lack capacity. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The home was maintained to a high standard and there was a rolling programme of refurbishment and redecoration. Service users had access to all parts of the home assisted by aids to daily living Service users choice regarding where they wished to take their bath would be enhanced by the utilisation of the first floor bathroom. EVIDENCE: The home was accessible, safe and well maintained. Aids to daily living were provided to promote the independence of service users. The home was clean and hygienic. Individuals liked their bedrooms and were happy with the facilities in the home. Service users had access to the garden and patio area. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 18 It was recommended that an assessment is made of all windows in the home to ensure the security of the building and safety of residents. Window restrictors should be fitted to first floor windows. The proprietors have confirmed that window restrictors have been fitted to ground floor windows where they have risk assessed that there is a security concern. A recommendation has been made regarding this matter. (Recommendation 3). Discussions took place with the proprietor regarding the use of bathrooms. All residents were being bathed in the ground floor bathroom. One bathroom on the first floor with a walk in bath/shower had been converted into a hairdressing salon. The other was not useable as it was being used for storage, was not regularly cleaned and did not have a lock on the door. It is recommended that a bathroom on the first floor be made operational in order to provide people who use the service with choice as to whether they wish to bathe in the ground floor bathroom or whether they would prefer to use one on the first floor close to their bedrooms which may offer more privacy. The proprietor was advised to fit an appropriate lock (that was acceptable to the fire officer) to the first floor bathroom door. (Recommendation 4) Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels are sufficient to safeguard the welfare of service users living in the home. Full and robust procedures, including vetting of work permits, must be undertaken by management to ensure that service users are appropriately supported and protected at all time. The quality of the service would be further enhanced by increasing training for all care team members. EVIDENCE: Service users and relatives spoken with stated that they considered there were sufficient staff on duty. Care staff also confirmed that they considered there were sufficient staff in their team. The home employed a team of 28 care staff and this provided for three carers and 1 manager on duty throughout the day supported by a cook and catering assistant, and two domestics. There were three night staff (two waking and one person sleeping in). It was understood that 12 care staff had attained NVQ level 2 in health and social care. The National Minimum Standards state that a minimum ratio of 50 trained members of care staff should have attained NVQ level 2. At the present time the home has approximately 44 . A recommendation has been made as part of this report that additional NVQ training should be taken up to Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 20 ensure that service users needs are attended by suitably qualified, competent and experienced care staff. (Recommendation 5). An inspection was made of a small random sample of staff files. It was noted that there were some omissions in the documentation needed to determine whether an applicant was suitable to work with vulnerable people in a care home setting. These matters were discussed with the manager on the day who was made aware of the need to ensure that all documents outlined under regulation 17(2) and Schedule 4 of the Care Homes Regulations were obtained. It was noted on the day that there was no work permit on record for a foreign national working in the home and the manager was asked to address this situation without delay. A requirement has been made in relation to this matter (Requirement 5). The proprietor has subsequently confirmed following the inspection visit that all documents required to confirm permission to work have now been obtained. Staff spoken with stated that they received regular updates for moving and handling training and this had been carried out by Newcastle-under-Lyme College. The latest recruit was not included on the training matrix and it was not possible to identify whether she had undertaken formal Induction Training. The carer confirmed that she had been supported by the registered manager and had shadowed experienced staff. The manager was aware of the need to ensure that the training record was current and accurate. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,36,37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is owned and managed by a family group and is operated in the best interests of service users. EVIDENCE: Service users spoken with knew the management structure of the home and felt that the home was well run. The owner/managers were in the home on a daily basis. Several service users stated that they felt that “this is my home” and “it is much better than any other home I have lived in”. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 22 There was a low staff turnover and several had worked in the home for many years. Staff appreciated the relaxed management style and felt they had a comfortable working environment. It was recommended that a regular quality audit (Service Use Satisfaction Survey) be carried out to demonstrate that the home is run in the best interests of service users. (Recommendation 6) The results of surveys should be published and made available to current and prospective service users, their representatives and other interested parties. There was no evidence to confirm that regular staff meetings or supervision were taking place and discussions took place with the manager regarding this issue. The manager spoke of staff reluctance to attend these procedures, however, it is imperative that this situation is appropriately managed. A recommendation has been made as part of this report (Recommendation 7). It was noted that Individual Fire Risk assessments needed to be carried out and a requirement has been made regarding this issue. (Requirement 6) Fire training should be provided to all staff to comply with Fire Regulations i.e. six-monthly for day staff and three-monthly for night staff to promote the safety of people who use the service. (Requirement 7) Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 3 1 Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 24 Yes, see below 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 OP1 Regulation 4(1)(c) Schedule 1 Timescale for action The Statement of Purpose for the 31/07/07 home should be reviewed to provide a statement as to the facilities and services which are to be provided and a statement as to the matters listed in Schedule 1. Prior to admission to the home the registered person shall confirm in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of his health and welfare. This will ensure that people who wish to reside in the home are assured that their needs will be met. Previous requirement. Timescale of 10/09/06 not met. The registered person shall ensure that the service user’s plan is regularly reviewed, together with the individual should they so wish, and updated to give a current DS0000005030.V347321.R01.S.doc Requirement 2 OP4 14 (d) 31/08/07 3 OP7 14(2) & 15(1)(2) 31/08/07 Wall Hill Version 5.2 Page 25 4 OP9 13(2) 5 OP29 17(2) & 19(1)(a) 6 OP38 14(4)© (iii) 7 OP38 23(4)(d) and (e) indication as to the health, personal and social care needs of the person. This will ensure that the plan sets out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user are met. Prescribed creams and aqueous creams should not be stored in communal bathrooms but should be safely stored. This will ensure that creams are administered as prescribed and will also eliminate risks of cross infection. Full and robust procedures, including the vetting of work permits, must be undertaken by management to ensure that service users are supported and protected at all times Fire Risk Assessments must be carried out on all residents to ensure that in the event of fire all persons can be safely evacuated or safely placed. This will protect the people who use the service and staff. Fire training should be provided to all staff to comply with Fire Regulations i.e. six-monthly for day staff and three monthly for night staff to promote the safety of the people who use the service. Previous requirement. Timescales of 30/05/05 and 10/09/06 not met 31/07/07 31/07/07 31/07/07 31/08/07 Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations It is recommended that medicines/tablets be transferred from the medication cassettes into a medipot before administering to residents rather than into the hand. This will ensure that the risk of cross contamination and cross infection are eliminated. It is recommended that individual preferences for dietary needs are catered for. For example vegetarian gravy/sauces should be provided for vegetarians. It is recommended that window restrictors are fitted to all first floor windows and that an assessment regarding security of the building be made in relation to ground floor windows. Where a risk is identified window restrictors must be fitted. This will ensure the health and safety of service users. It is recommended that the bathroom on the first floor is made operational in order to provide people who use the service with choice as to whether they wish to bathe in the bathroom on the first floor close to their bedrooms or whether they wish to walk downstairs. The first floor bathroom door should be fitted with an appropriate lock, acceptable to the fire officer to provide privacy for residents. It is recommended that staff working in the home undertake training in NVQ level 2 in health and social care in order that the people who use the service may be assured that their needs are attended by suitably qualified, competent and experienced care staff. It is recommended that a regular annual quality audit (Service User Satisfaction Survey) based on seeking the views of service users and their advocates is carried out. This will ensure that the home is run in the best interests of service users. It is recommended that regular staff supervision takes place that covers all aspects of practice, philosophy of care in the home and career development needs. This will ensure that all staff in the home have a clear understanding of the aims and objectives of the service and that their training needs are regularly reviewed. It was recommended that the record of food served to DS0000005030.V347321.R01.S.doc Version 5.2 Page 27 2 3 OP15 OP19 4 OP21 5 OP28 6 OP33 7 OP36 8 Wall Hill OP38 I residents that was different to the main menu is maintained in the kitchen diary in order to identify what food had been served to individuals and on what day. Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Stafford Local Office Dyson Court Staffordshire Technology Park Beaconside STAFFORD ST18 0ES National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Wall Hill DS0000005030.V347321.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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