Inspection on 12/11/09 for Waratah House

This inspection was carried out on 12th November 2009.

CQC 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 CQC 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

Waratah House 24/09/08

Waratah House 12/06/07

Waratah House 18/04/06

Waratah House 28/11/05

Waratah House 23/05/05

Waratah House 08/11/04

Waratah House 10/06/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/03/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Waratah House Sanderstead Road Sanderstead Croydon Surrey CR2 0AJ Lead Inspector Janet Pitt Key Unannounced Inspection 12th November 2009 11:00 DS0000025866.V378908.R01.S.do c Version 5.3 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Waratah House DS0000025866.V378908.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Waratah House DS0000025866.V378908.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Waratah House Address Sanderstead Road Sanderstead Croydon Surrey CR2 0AJ 020 8651 0222 020 86577694 thewaratah@btconnect.com 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) Mr James Emmanuel Kwabena Safo Mrs Jawaixa Goliath Care Home 54 Category(ies) of Dementia (25), Mental disorder, excluding registration, with number learning disability or dementia (29) of places Waratah House DS0000025866.V378908.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE (Maximum number of places: 25) Mental Disorder, excluding learning disability or Dementia - Code MD (maximum number of places: 29) The maximum number of service users who can be accommodated is: 54 24th September 2008 2. Date of last inspection Brief Description of the Service: Waratah House is situated in the Sanderstead area of the Borough. The property consists of a large detached building, with two additional annexes. There is a large patio to the rear of the home, with car parking facilities. The home lies on a very busy main road, (which, it has to be said, is not pedestrian friendly), and is on a bus route and close to a rail station. The home provides care for older people living with dementia or mental health needs. Information on what the home can provide is available in the Service User Guide, which is made available to current and potential Service Users. Additional information can be found in the home’s Statement of Purpose. Fees for this service are £450 - £500 per week. Waratah House DS0000025866.V378908.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors undertook this unannounced inspection. A site visit was made which lasted four hours. During this time records relating to staff recruitment, care plans and medications were examined. We undertook a tour of the premises and were able to speak with people that live in the home. Staff members were spoken with and we observed the lunchtime meal. The home provided us with their Annual Quality Assurance Assessment (AQAA). Information from the AQAA has been included in this report. Other information that we hold such as notifications and Safeguarding alerts have also been used. What the service does well: The rating for the home is one star. This means that the people who live in the home experience adequate quality outcomes. The home considers that it ‘provides excellent care for all the service users. All our staff have the interest of the resident at heart. Their welfare is of paramount concern and is promoted by staff that respects them and treats them with dignity.’ We were not able to find sufficient evidence to support this statement and are concerned that the home has not managed to sustained improvements made. Mealtimes are now more relaxed the food looked appetising and was well presented. People were clean and tidy and dressed well in clothing of their choice. What has improved since the last inspection? The home considers ‘We have improved tremendously. We have had the input of the Care Home Support Team and they have entrusted us with good quality training and suggestions as to enhance our residents lives.’ The initial improvements have not been consistent and tensions within the staff team have caused the home to become adequate. The manager and responsible individual are working towards giving a good service, but this needs to be embraced by all staff members. Waratah House DS0000025866.V378908.R01.S.doc Version 5.2 Page 6 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Waratah House DS0000025866.V378908.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 Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People need to be sure that their needs will be assessed appropriately. Assessments contained scant details of what assistance a person required. EVIDENCE: We looked at the assessments of people in the home. We found that a preadmission assessment had been carried out by the home manager prior to the person moving in. A further assessment of need was undertaken when the individual moved into Waratah House. This document consisted of tick boxes, with space for additional comments to be made. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 Page 9 Areas assessed included mobility, continence, appetite, personal hygiene, oral hygiene and dressing. There was limited evidence of people’s preferences. Some examples included a section on personal hygiene not being completed and no supporting evidence had been recorded on the person’s plan. Therefore we were unable to know what care the individual needed. We were unable to identify exactly what assistance is needed and what the person is able to do for themselves. There was some information on the individuals’ social history, but again details were scant. Staff must make sure that people that live in the home have a comprehensive assessment of need in place to make sure that the home can demonstrate its ability to meet need. Assessments were generally reviewed six monthly, but this was not consistent. People had a transfer letter in their file that is completed if they need to go to hospital, but there was no evidence that these letters had been used. Each individual had a contract with the home and a service agreement with their placing authority if needed. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals need to be confident that their assessed needs will be met. Care planning must involve the person and show that they will be treated with dignity. A clear medication trail is needed to make sure that people can be confident their medicines will be handled and administered safely. EVIDENCE: The homes states in its AQAA that they: ‘All service users or their relatives are involved when evaluating care plans. Maintaining independence is our aim thus we encourage all resident to actively participate in care planning.’ When we examined peoples care plans we could not find consistent evidence of individuals being involved in the process. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 Page 11 Generally the plans met the minimum standard, but need improvement to make sure that the home is demonstrating how assess needs are met. We found that there were two different systems. There were two types of care plans in place. The deputy manager told us that the home was in the process of introducing a new care plan, which was why there were two systems being used. However, we found on all plans examined that there was limited detail on a person’s cultural or religious needs. Promotion of an individual’s independence was brief. We found records of visits by other professionals, such as the general practitioner, opticians and dentists had been recorded. We are concerned that when a person loses a significant amount of weight, the home is not proactive in making sure a dietician referral is made alongside requests for blood tests. Management of diabetic individuals should be managed better. We found that one person’s blood sugar level was consistently high, but no effort had been made for a professional to review this person. Some plans that we looked at contained language that was demeaning to the person, such as ‘very often declines any assistance given’ and ‘enjoys a bath.’ However, there were instances of the use of the word ‘refused’, such as ‘refusal of nightly house checks. Staff must make sure that they evidence real choice for people that live in the home. We noted that staff ignored the wishes of the person. Staff were checking a person every three to four hours, even though the individual had specifically said they did not want this to occur. People in the home need to be confident that they will not be deprived of their liberty. One person liked to close the curtains in the lounge, but was prevented from doing this by staff. A member of staff said there was a risk assessment in place, but we could not find it. Risk assessments must evidence how restrictions of liberty are monitored and assessed as essential. Overall risk assessments were vague and too generalised to know what the actual risk was. An individuals sexuality needs had not been consistently addressed. Entries such as ‘not discussed’ were common. Plans were seen to be evaluated monthly and daily records contained information on basic care needs being met, for example baths and showers. However, when plans had been re-written they had not been fully completed. Daily records should fully detail how all needs are being met. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 Page 12 There were limited details on how staff should intervene when a person was verbally or physically aggressive. When we looked at medications in the home, we found weaknesses in the system used. The lack of a good audit trail puts individuals at risk of harm. We found there were gaps in recording that had not been investigated. There were instances of medication being signed for but not given and medication being given but not signed for. This was discussed with one of the responsible individuals after the site visit. They said that an audit of medications had been undertaken the day before the site visit and they were aware of the issues raised by us. We explained that we would need the home to confirm that action had been taken. One person had a risk assessment for their own herbal medications. We could not find clear details of the medicines were any side effects or how to deal with adverse reactions. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home should be able to continue with hobbies and interests. Individuals should be able to choose whether they wish to engage in activities. EVIDENCE: AQAA consider that do well. ‘We offer clients alternatives at mealtimes. We offer to residents to make their own sandwiches on the kitchen as well as baking cakes for afternoon teas. Clients who are able to go out on their own are encouraged to do so.’ Peoples care plans had some detail of their hobbies and interests. There was some evidence that this had been incorporated into their daily lives. For example one person enjoyed ballet and musical films, their daily records showed that they were able to continue these interests. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 Page 14 However, staff did not always respect an individual’s right not to engage socially. One person’s assessment stated that they preferred their own company. However, their plan for social activities included instructions for the person to ‘come to the lounge and take part in conversation with other clients.’ The home acknowledges that more external outings would be beneficial and are planning to employ a minibus driver, so that more trips into the community can be made. Some people are able to go into the community on their own. There was appropriate guidance in place for this. When we observed the lunchtime meal we found there were some good practices. Staff were seen to be sitting to assist individuals with their meals. There were choices for the main and pudding course. Staff brought the desserts on a tray so individuals were able to see what was available. We noted that portion sizes were good and the meal was served with gravy. After the meal people were able to sit in the lounge area. The furniture could be rearranged to allow more interaction between the people that live in the home. Fruit and beverages were placed on the coffee table, but not everyone was able to walk to the table to get them. We saw that some of the chairs did not have seat covers and there was an odour of urine in the room. We observed one person walking around eating a banana, a member of staff repeatedly tried to make them sit down. Another person was also walking around. Again staff were making them sit down. We heard a member of staff say ‘we don’t want you to have another fall.’ Staff should examine their practice around caring for individuals with Dementia and alter it to make sure people are able to move freely with appropriate supervision. We noted that one person was sitting in the main lounge with the wire of the television aerial over the arm of their chair. The home has another smaller lounge and we found that the television was not correctly tuned in. This has been a persistent problem for quite a while. The home must make sure that the problem is rectified, as we have received complaints from people about the poor reception. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People need to be confident that any concerns will be handled well. Accurate records need to be maintained of any incidents or complaints. Staff must make sure that the Care Quality Commission are informed without delay of any serious incidents in the home. EVIDENCE: The home’s AQAA states: ‘All complaint is dealt with by the manager.’ ‘All clients and relatives are aware of our complaints procedures.’ When we looked at the information provided in the AQAA we noted that the home have received six complaints, one of which was resolved in the timescale. However, there was no further information on the outcome of the other five concerns. During the past twelve months there have been fourteen safeguarding alerts. These were all investigated and two were substantiated. One related to diabetic care, management of medication and care planning. The second Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 Page 16 related to an individual falling. During the site visit we found a Regulation 37 notice detailing the incident. However, this had not been forwarded to us. The AQAA told us that there had been one incident when restraint was used, we did not receive a formal report on this and what actions had been taken. reported to CQC. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally people live in a home that is clean and maintained. Attention is needed to make sure that this is consistent. EVIDENCE: Waratah states in its AQAA that there are plans improve the exterior of the home and ‘provide a proper garden’. When we had a look around the premises we found that it was generally well maintained. There were some issues for example a smell of urine in the main lounge and outside the kitchen door a telephone wire needed to be secured to the wall. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 Page 18 People are able to personalised their rooms and have suitable private and communal space in which to live. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home should be supported by trained and competent staff. Specialist training is needed in Dementia Care to make sure that individuals are properly supported. EVIDENCE: The AQAA informed us that the home has ‘a training plan in action’ and that senior staff are qualified to NVQ Level 3. Junior staff have NVQ Level 2 or are working towards it. When we looked at training records we found that Dementia training had not been provided by an external trainer as recommended in previous inspection reports. We are concerned that this has not occurred, as we observed poor practice by staff when dealing with the people that live in the home. (See section on daily living.) We looked at staff recruitment files and found that all necessary checks had been carried out such as Criminal Records Bureau checks and two references. The manager stated in the AQAA that they plan to improve recruitment of staff by making sure that they are involved in the process, instead of relying on an Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 Page 20 external agency. The manager would like to be able to selected and develop the staff team. Staff at Waratah have been working with the Care Home Support Team on issues such as record keeping. However, all staff need to be proactive in implementing changes and putting their training into practice, as this has caused standards to deteriorate. Staff do not provide consistent approach in meeting the needs of people that live in the home. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People need to benefit from living in a home that is run in their best interests. A proactive staff team would make sure that improvements are consistently maintained. EVIDENCE: From the care plans we found that the majority of peoples finances were managed by their representatives. Some records of monies are kept in the home. These were found to be accurately maintained. However, it is recommended that records of clothes bought include detail of the types of garments. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 Page 22 The AQAA informed us that the home now benefits from a full time administrator. We noted from the AQAA that some policies and procedures had not been reviewed or updated since 2003. In particular those relating to confidentiality and disclosure of information, bullying, accidents to service users, food hygiene, management of service users money, missing service users, Safeguarding, values of privacy dignity, choice, fulfilment, rights and independence. During the tour of the premises we found Asbestoses under the stairs and on the door of staff cloak room. The home must made sure that this is addressed by the appropriate authority and made safe if needed. We were unable to evidence Portable Electrical Testing records at the time of the site visit. However, the AQAA stated that appliances had been checked in May 2009. Records relating to gas safety were also not available. The AQAA informed us that these checks were last carried out in August 2008. The home needs to make sure that all safety checks are carried out routinely as required by guidance. Records relating to these checks must be available for inspection, in order that we can verify that people are not at risk of harm We found that a notification had not been placed in the individual’s file, which made tracking a concern difficult. The AQAA was generally well complaeted, but care is needed to make sure it accurately reflects the current running of the home. All staff need to make sure they are working toward meeting the standards. Some staff members are proactive in their work, but other staff members who do not put training into practice, such as wordage in records, are causing the home not to meet the required standard. Thus not enabling the people that live at Waratah to lead fulfilled and meaningful lives. The manager was not available on the day of site visit, but we spoke with one of the Responsible Individuals. We discussed out concerns that after achieving a good rating, the home is now ‘drifting’ and poor practice is occurring. Any previous gains the home has made are not being consistently applied which has affected the overall rating. We requested audited accounts for the service and found there to be an adequate budget in place to run the home. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 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 X 3 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 2 2 Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP3 Regulation 14 Requirement Peoples assessments must be comprehensive and identify assistance needed. This will make sure that people can be confident that all their social and health needs are identified. Individuals care plans must lead from assessments and fully reflect needs and choices. This will make sure that people can be confident that their needs will be met appropriately. There must be a clear audit trail of medications in place. This will make sure that individuals can be confident that medications are handled and administered safely. Care must be taken to make sure that language used in care plans are not derogatory to the person. This will evidence that individuals are treated with respect. Equipment supplied for the purposes of relaxation and entertainment should be in good working order. This will make sure that people are able to DS0000025866.V378908.R01.S.doc Timescale for action 30/06/10 2 OP7 15 30/06/10 3 OP9 13 (2) 30/06/10 4 OP10 12 (4) 30/06/10 5 OP14 23 (2) (c) 30/06/10 Waratah House Version 5.3 Page 25 6 OP14 12 (4) 7 OP16 22 8 OP18 37 9 OP26 23 (2) (d) 10 OP30 18 (1) 11 OP30 18 (1) 12 OP33 12 (5) 13 OP38 23 (2) (c) enjoy their pastimes. Dementia care must include appropriate support for activities of daily living. This will make sure that people are treated with respect and their dignity maintained. Complaints records must fully evidence the process followed, with actions and outcomes in place. This will make sure that people can be confident that any concerns they have will be taken seriously. Procedures must followed to make sure all relevant authorities are notified of incidents in the home. This will make sure that the home is demonstrating that it is run in an open and transparent way. Routine cleaning is needed to remove the smell of urine in lounge. This will make sure that people live in a pleasant environment. Staff must make sure that any training they receive is put into practice. This will make sure that care given is consistent and of a good quality. Training in Dementia Care must be provided by an external provider. This will make sure that staff are competent in Dementia care. Staff must work in best interest of people that live there. People’s views and choices must be listened to acted upon. This will make sure that people are treated as individuals and their dignity is maintained. Routine Portable Appliance testing and gas safety checks must be done. This will make sure that individuals live in a safe environment. DS0000025866.V378908.R01.S.doc 30/06/10 30/06/10 30/06/10 30/06/10 30/06/10 30/06/10 30/06/10 30/06/10 Waratah House Version 5.3 Page 26 14 OP37 12 15 OP38 13[3] 13 [4]a,b,c Policies and procedures must be 30/06/10 reveiwed and up dated regualrly. This will make sure that staff are aware of current guidance and advise in care practices. The home must consult the 30/06/10 ‘Health and Safety Executive’ (regulation 23[5]), and provide evidence, that any suspected asbestos containing products within the home have been professionally identified, then labelled, sealed and left, or safely removed as risk assessment indicates, and under Health and Safety regulations. (See also, Regulation 4 of the Control of Asbestos at Work Regulations 2002.) This will make sure that individuals live in a home that is free from hazards. 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 OP12 Good Practice Recommendations Consideration should be given to providing training on meaningful activities to key members of staff. Staff should record activities as well as the physical care provided. Consideration should be given to including more interactive items in the communal areas of the home for people living with dementia. 2. OP12 3. OP19 Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 Page 27 Care Quality Commission London region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Waratah House DS0000025866.V378908.R01.S.doc Version 5.3 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!